Elderly patients with end-stage kidney disease(ESKD) are more concerned about dialysis or not than when to start dialysis. Currently, the treatment guidelines needed for elderly patients with ESKD include dialysis method, number of dialysis sessions, and whether or not to receive dialysis. First, various studies have shown that dialysis provides superior clinical outcomes for patients than conservative treatment. However, due to the research method, RCT is difficult, so there are limitations in making conclusions and developing treatment guidelines. Compared to dialysis, the choice of conservative treatment requires the development of active conservative treatment that is not yet established. Second, most studies on dialysis method decision-making reported that hemodialysis had a better prognosis than peritoneal dialysis patients. Treatment guidelines for selecting hemodialysis and peritoneal dialysis appear to be subject to change due to technological advancements in dialysis, and also contain issues of selection bias and fair information provision, so a patient-tailored approach is still important. Third, the number of hemodialysis sessions is an important topic for elderly patients with ESKD, and our research team is conducting the PRIDE(2 vs 3 session of hemodialysis for elderly ESKD patients) RCT. Research and treatment guidelines that take into account the various characteristics of the elderly are not easy, but they will play an important role in the treatment of patients with ESKD.