The SDM is a computerized, workflow driven version of the RPAs Shared Decision Making Guideline (http://www.renalmd.org/catalogue-item.aspx?id=682). It offers nephrologists the tools and recommendations with which they can aid adult and pediatric patients who have AKI, CKD, or ESRD in initiating, withholding and withdrawing dialysis . This app combines the benefits of the printed guideline (consensus expert opinion informed by ethical principles, case and statutory law, and systematic review of research evidence) with a step-by-step approach to working through the process of decision making with the patient and their family. Highlights include specific pathways for initiating, withholding and withdrawing dialysis, real-time calculators of the most common scoring systems used to quantify symptoms, and links to many web-based resources. While this app does not store data, it does offer the abiity to compile the work done into a document suitable for printing and scanning for storage in paper or electronic charts. It is provided free of charge by the Renal Physicians Association and DaVita Inc. and recommended for renal and other kidney care providers.