Background: The CKD population is becoming increasingly elderly with multiple comorbidities. For this reason, accurate predictive information related to the progression into ESRD, mortality, and functional decline is critical to allow for optimal shared decision making (SDM). Summary: This review will assess the current literature on the methodologies for the estimation of prognosis and prognostic tools developed for CKD. A practical clinical approach is discussed that involves the estimation of prognosis and integration of prognosis into SDM. Key Message: There are validated, easy-to-use prognostic tools that help clinicians engage in effective shared decision making with their CKD patients and family.

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