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Tamara Rubenzik and Holly Yang

Effective communication is necessary when providing medical care but can prove challenging when attempting to match patients’ values to therapies. Nephrologists often participate in difficult conversations with patients and their families, most commonly involving dialysis in patients with chronic kidney disease (CKD) and ESRD. Despite this, most nephrologists and nephrology fellows do not feel prepared for these difficult conversations (13).

In recent years, there has been an increasing focus on goals of care and utilization of a palliative approach in advanced CKD and dialysis care. The aim is to address the symptoms, pain, and stress of