Improving Medical Decision Making for Older Patients With End Stage Renal Disease

Inclusion Criteria:

   - Patients age ≥70 are eligible if they have EITHER Advanced CKD defined as ONE eGFR
   value ≤ 30 ml/min/1.73m2 in the past 12 months NOT determined to be a result of AKI OR
   Have a diagnosis of CKD and less than a two-year prognosis from any cause, defined by
   the clinician answering "NO" to the Surprise Question ("Would you be surprised if this
   patients died in the next two years?")

   - Patients age 65-69 are eligible if they have BOTH Advanced CKD defined as ONE eGFR
   value ≤ 30 ml/min/1.73m2 NOT determined to be a result of AKI AND Have less than a
   two-year prognosis, defined by the clinician answering "NO" to the Surprise Question
   ("Would you be surprised if this patients died in the next two years?")

   - Patients who have not had a nephrology visit in the past 12 months can be recruited
   from non-Nephrology Clinics per the above eligibility criteria

Exclusion Criteria:

   - listed for kidney transplantation or previous transplant recipient

   - already on or previously on dialysis (including emergent dialysis)

   - new patient visit

   - visually impaired beyond 20/200 corrected

   - psychological state not appropriate for ACP discussions as determined by the primary
   nephrologist

   - cognitive impairment