There are approximately 50,000 people in the UK on renal replacement  therapy (RRT) and this number is increasing each year. In an average GP practice there will be one or two patients currently on RRT and a larger number with progressive chronic kidney disease who will reach end stage renal disease (ESRD). The options for RRT are kidney transplantation, haemodialysis (HD) or peritoneal dialysis (PD). The management of an individual with ESRD may involve all of these modalities during the course of their lifetime. For many patients with ESRD, treatment at home allows greater flexibility and independence than can be facilitated by inpatient HD. Others value the security of receiving their RRT in a hospital environment and would resent the intrusion of dialysis into their home life. All patients appreciate early information about the options for RRT so that they and their family can make an informed decision about the best treatment for them. The aim is to provide personalised information to patients at least three months before they need to begin RRT.