There is increasing interest in the use of MI with patients with CKD. Successful
management of CKD typically involves improving diet, increasing physical activity, quitting
smoking, and controlling fluid intake, blood pressure, blood sugar, and phosphorus. In
addition, patients consider a variety of treatment options (e.g., home versus clinic-based
dialysis, choosing fistulae versus catheters for hemodialysis access) that they must adhere to
for the treatments to work well. The complexity of behavioral changes and treatment
decisions, combined with the fact that many patients have not yet begun to feel the effects of
their illness, could diminish their motivation to address CKD and lead to poorer treatment
outcomes. Hence, motivational enhancement, in the context of patient education and shared
decision making with the treatment team, is a critical issue in CKD patient care.