**7. Strategies for improving SDM in the choice of renal replacement therapy**

Patients with CKD have numerous sources of information which could help them to make an informed decision. The nephrologists, due to their medical competence, could play a main role in providing medical advice. Moreover, Nurses can play a crucial role in explaining the available choices of RRT in and in providing emotional support for them. Patient's family members could be engaged in decoctions and providing support [23].

In a recent study, Stoye et al. [23] conducted a study to explore nurses' and nephrologists' perceptions of their participation in shared decision-making for selecting renal replacement therapy. The results showed that due to the high disease burden on patient's life, shared decision-making for the selection of renal replacement therapy is mostly difficult issue. Providing full education and training for patients and the consistent participation of nursing staff and peer education facilitated the SDM process [23].

Although nephrologists and nursing professionals are professional experts, family members of patients and peers are considered experts by virtue of their experience [30]. Structured peer mentoring programs or peer counseling could help patients to select a desired option.

Shifting the paradigm of medicine from a predominant biomedical and technical orientation to a person-centered orientation of SDM might improve decision-making practices [31].
