THIS IS THE first article in a 2-part series, which is intended to promote an appreciation and advocacy of Advance Care Planning (ACP) for Registered Dietitian Nutritionists (RDNs) in nephrology practice. The first articlewill describe the utilization of palliative care and hospice care among end-stage renal disease (ESRD) patients. The second article in this series will describe the RDN’s role as a key advocate of the interdisciplinary team in the ESRD setting at this critical and sensitive stage of patient care. Elderly patients with ESRD often have significant comorbidities and other deficits that affect their quality of life. An increasing awareness of the burden and impact of ESRD on patients and families is stimulating the development of a framework for ACP in ESRD care. The goal of ACP is to encourage more open discussions involving the complex decisions that relate to the initiation and the withdrawal of dialysis; and the Renal Physicians Association (RPA) has produced valuable resources including guidelines and tools for addressing the complexities of end-of-life decision-making in ESRD patients.