Background Advance Care Planning (ACP) helps communicate patients’ preferences, particularly for older and chronic patients.

Aim To determine what was most important to patients whit End-Stage Renal Disease (ESRD), if they wanted to participate in decision-making process and what degree of functional impairment they would consider intolerable.

Methods Prospective qualitative study carried out on selected ESRD patients from a dialysis unit. Two semi-structured interviews with each patient were performed, including their relatives.

Results From May to November 2013 fourteen patients (9 male and 5 female) with an average age of 66 years were interviewed. They believe that the information process is adecuate, but there is no information about the plan of care if a trasplant is not a real option. Patients would like to participate in decisions concerning their care and end-of-life. They would want to keep on with dialysis treatment while their quality of life continues to be acceptable for them. Respecting end-of-ife care, dying without pain and to be cared for at home are the most important points for them. Patients think that doctors don’t speak to them about end-of-life because they are focused on other aspects of care.

Conclusion Although there are great opportunities to talk with ESRD patients about end-of-life care this is often not done. In cases with severe cognitive impairment they would prefer to withdraw dialysis. Then they wish to receive care at home to relieve suffering or pain. The best way to achieve this is by integrating palliative care into dialysis units.