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The use of SDM is increasingly recognized in the context of selecting kidney replacement therapy (KRT) for patients with chronic kidney disease (CKD). This study reviews the general concept of SDM and global clinical studies on its application in selecting KRT options. Studies have demonstrated the significant benefits of SDM in KRT, including enhanced patient knowledge, satisfaction, autonomy, and increased peritoneal dialysis (PD) selection rates, which may contribute to cost savings. However, challenges remain in implementing SDM owing to time constraints, its dynamic nature, and insufficient incentives. Building on established frameworks, particularly Clayman\u2019s six-step model, we propose a new six-step SDM framework tailored to KRT to facilitate its implementation and promote adoption. 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