There is increasing recognition that shared decision making (SDM) can improve decisional quality and satisfaction among persons with advanced chronic kidney disease (CKD) facing decisions about kidney replacement therapy. SDM involves a process whereby clinicians present harms and benefits of treatment options early and neutrally and help patients and their care partners select a treatment that aligns with their priorities.1,2 This is especially important for older patients, who may not experience dialysis as a bridge to transplant or life-prolonging therapy, and who may experience significantly decreased quality of life with dialysis.