Background/purpose: There is increasing recognition of the need to integrate advance care planning (ACP) into end-stage renal disease (ESRD) care with attention to medical, ethical, psychosocial, and spiritual issues but publications comparing patients who chose renal replacement therapy (RRT) and renal palliative care (RPC) is scarce. We here share our experience on ACP for ESRD patients in a center with renal replacement and palliative programs in place. Methods: From June 2006 to December 2011, ESRD patients were empowered to make an informed choice of future medical care in a structured ACP that was emphasized to be an ongoing process. Patients who opted for RRT and RPC would be followed up at the predialysis clinic and the one-stop multidisciplinary RPC clinic, respectively. This was a single-center study in a secondary care hospital. A total of 600 patients (265 RRT, 335 RPC) were enrolled and followed up over a median of 782 days. Results: The majority of patients and relatives declined dialysis because of perceived physical burden. Only 1.6% of palliative care patients changed their decision and commenced dialysis. Baseline characteristics differed between patients who chose RRT or RPC. Survival declined according to the modified Charlson Comorbidity Index scores. Older age, mental incompetence, hyperlipidemia, high modified Charlson Comorbidity Index, low estimated glomerular filtration rate, and low albumin were important independent predictors of poor survival. Factors affecting the ACP decision were discussed in the Chinese culture context. Conclusion: A structured ACP could empower the patient to make an informed decision on the management of ESRD. @?@?: @?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?(ACP)@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@? @?@?: @?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?265@?@?@?@?@?@?@?335@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?782@?@? @?@?: @?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@? @?@?: @?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?@?
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