**6. Outcomes of shared decision-making for selection of RRT**

According to the literature review, SDM is considered an important factor for positive patient-centered outcomes. Successful SDM could increase patients' adherence and compliance, their satisfaction, as well as the promotion of awareness about the disease. Moreover, SDM can decrease the cost of treatments and reduce the symptoms [25].

A study in Germany conducted by Robinski et al. showed that successful shared decision-making is one of the main factors increasing the satisfaction of dialysis patients on long-term treatment [26].

Patients with ESKD need to be assisted and encouraged to choose the most suitable renal replacement therapy in an active manner proactively rather than being passive and relying on healthcare professionals' decisions. Patients' participation in the decisions could improve the patients' empowerment and autonomy in making treatment decisions [27].

During the SDM process, healthcare professionals provide information and evidence regarding different types of treatments, whereas the patients express their own preferences and opinions. The exchange of this information could help to ensure that patients and their families understand the appropriate information, thereby it reduces decision conflicts [28]. Moreover, receiving support during the effective SDM increases patients' self-efficacy [20]. Moreover, it has also been reported that SDM can optimize decisional outcomes, improve treatment compliance, reduce anxiety, and lower demand for healthcare resources [29].
