Abstract: Management of vascular access is a key step in maintaining hemodialysis efficacy. Appropriate selection and long-term maintenance of vascular access directly impact on quality of life of the patients. The lifelong management of vascular access encompasses the entire process from planning and establishment to utilization and removal, which involves multifactorial clinical evaluations and requires integration of evidence-based guidelines, patient preference, and healthcare resources. Shared decision-making is a patient-centered model emphasizing joint participation of physician and patient in treatment decisions, and is a valuable method of vascular access management. This paper systematically reviews current application of shared decision-making in lifelong management of vascular access, analyzes key challenges in clinical practice, and proposes targeted promotion strategies, aiming to provide theoretical references and practical guidelines for establishing a scientific and systematic decision-making framework for vascular access in patients with chronic kidney disease.

Key words: Shared decision-making, Chronic kidney disease, Vascular access, Full life cycle