# Construction of the ESKD Life Plan

> **NIH NIH R03** · UNIVERSITY OF CALIFORNIA LOS ANGELES · 2021 · $117,000

## Abstract

PROJECT SUMMARY/ABSTRACT
Decisions about vascular access in patients with end-stage kidney disease (ESKD) who are hemodialysis
dependent can strongly influence clinical outcomes of vascular access longevity, need for revision procedures,
repeat access operations and hospitalizations which in turn affect patients' quality of life. Addressing this, the
pending update of the National Kidney Foundation Dialysis Outcomes Quality Initiative (K-DOQI) Clinical
Practice Guideline for Vascular Access recommends construction and regular update of an individualized
ESKD Life-Plan for each patient. Such vascular access Life-Plans encompass a specific plan for all of the
vascular accesses for an individual patient for the remainder of the patient’s hemodialysis-dependent life. Life-
Plans are to be developed by the provider team in conjunction with the patient, within a multidisciplinary team
framework. However, implementing K-DOQI-recommended Life-Plans can require considerable infrastructure
and may face significant barriers, as the concept of such an ESKD Life-Plan is entirely novel both to patients
and providers. The goal of the proposed research is to ascertain providers', patients' and relevant
stakeholders’ attitudes and preferences for how the multidisciplinary provider-patient discussions should be
conducted.
To overcome barriers to implementing K-DOQI guidelines, relevant patients and providers will be engaged in co-
developing a toolkit for ESKD Life-Plan implementation focused on patient engagement, shared decision-making
and barriers and facilitators to multidisciplinary collaboration. First, qualitative individual semi-structured
interviews with approximately 55 patients and providers will be used, enabling a) unrestricted exploration of the
topic; and b) participants to express attitudes and preferences in their own words. These data will then be used
to develop a prototype Life-Plan implementation toolkit that accommodates diverse patient preferences and
healthcare systems, and perform its initial field testing and peer review. This will inform future grant-funded
implementation testing to determine the toolkit's efficacy and utility in enabling and facilitating transition to the
new vascular access paradigm.
The Specific Aims are to:
1: Determine the attitudes and preferences of relevant patients and providers with respect to degree and
nature of their own involvement in shared decision-making and development of the ESKD Life-Plan.
2: Develop and perform initial field testing and peer review of a Life-Plan implementation toolkit that empowers
patients to engage in the vascular access shared decision-making process and offers methods to providers to
overcome challenges of the multidisciplinary team approach.

## Key facts

- **NIH application ID:** 10108408
- **Project number:** 1R03DK127131-01
- **Recipient organization:** UNIVERSITY OF CALIFORNIA LOS ANGELES
- **Principal Investigator:** Karen Woo
- **Activity code:** R03 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2021
- **Award amount:** $117,000
- **Award type:** 1
- **Project period:** 2021-03-01 → 2023-01-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10108408

## Citation

> US National Institutes of Health, RePORTER application 10108408, Construction of the ESKD Life Plan (1R03DK127131-01). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/10108408. Licensed CC0.

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