Jennifer E. Flythe, MD, MPH, a dialysis expert from the University of North Carolina, joins Kristin L. Walter, MD, MS, JAMA's Deputy Editor. They delve into the crucial decision-making process behind choosing hemodialysis or peritoneal dialysis based on patient symptoms and preferences. The discussion highlights the ineffectiveness of statins and ICDs for cardiovascular prevention in dialysis patients. They also explore managing common symptoms like pruritus and depression, while shedding light on the high mortality risk within the first six months of treatment.