Applying a Better Conversations Framework to Dialysis Decision-Making for Patients with Advanced CKD
In a perspective piece published in the Journal of the American Society of Nephrology, authors propose applying the "Better Conversations" framework to dialysis decision-making for patients with advanced chronic kidney disease (CKD). This five-step framework guides nephrologists through steps to share their clinical opinions, describe the goals and downsides of dialysis in terms of patient experience, and provides space for patients to deliberate on whether trade-offs align with what matters most to them. The authors argue this framework can help patients start dialysis with a better understanding of how it will support their goals, and opens the door to discussing alternatives like conservative kidney management.