***Comment***Patients with end stage kidney disease require complex care regardless of where they are within the disease continuum. The incorporation of nursing theory into the clinical care of patients with end stage kidney disease can enhance the overall care that is administered. Florence Nightingale identified the focus of nursing in relation to providing an optimal environment in which to foster health promotion and healing. Although the purpose of nursing may vary somewhat depending on the theorist, the common thread is the provision of care in a caring manner. The theory of Dorothy Orem can easily be integrated into the care of patients with end stage kidney disease. Orem defines self-care as the practice of activities that individuals initiate and perform on their own behalf in maintaining life, health, and well-being. Self-care also includes the care that is given by healthcare workers, family, or friends when an individual cannot provide aspects or complete care for themselves. Advanced kidney disease patients must make modifications to what they eat and drink, sleeping pattens are affected, energy levels are diminished, and complex medication regimens are required, as well as the ongoing treatment with some form of renal replacement therapy.

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