The current dialysis care model is largely disease-focused, designed to preserve longevity and minimize sequelae of end-stage kidney disease (ESKD), often with a goal of transplantation. Because many patients living with ESKD experience high rates of comorbidity, frailty, and mortality, these goals may not be realistic nor align with their priorities and preferences. Instead, these patients may benefit from a person-centered approach to care that emphasizes quality of life, minimizes disease and treatment-associated burdens, and promotes a timely transition to end-of-life care.