Education for patients with progressive CKD and acute-start dialysis.

For individuals living with CKD and those who have been discovered to have ESRD, the decisions facing them can be daunting. Such decisions include having renal replacement therapy (RRT) or conservative care, having a kidney transplant, or selecting a modality of dialysis that would fit their lifestyle and values. Education at this critical time is essential, but it must be tailored to the individual and his or her readiness to learn, and it must be provided with empathy and understanding of the chronicity of the disease and the magnitude of the effect of kidney failure on their life. We present strategies derived from education and psychology that can assist health-care practitioners to provide such education and support to individuals with advanced CKD. We also present an approach to educate and support those who have urgently started dialysis and require chronic RRT. This educational model has its basis in theories of education and decision-making and has been used with success in this population.