Between 1990 and 2016, the global prevalence of chronic kidney disease (CKD) increased by 87%,1 with nearly 40% of adults aged ≥60 years worldwide with CKD stages 3-5.2 With age, a person’s health goals and preferences often shift, moving beyond maintaining kidney function and survival to include priorities such as social support, physical well-being, participation in activities, and support of one’s decision-making capacity.3-5 These priorities can vary across individuals, underscoring the importance of tailoring kidney failure treatment decisions to what matters most to each patient.