O’Hare AM, et al. - Via a cross-sectional survey study of 996 subjects receiving maintenance dialysis at nonprofit facilities in 2 US metropolitan areas (Seattle, Washington, and Nashville, Tennessee) between April 2015 and October 2018, the researchers understood the prognostic expectations of subjects who were undergoing dialysis and how these were linked to care planning, goals, and preferences. About 185,427 prevalent US in-center patients who had undergone hemodialysis died within 5 years, 58,437 died within 5 to 10 years, and 63,738 lived for more than 10 years. The survey that respondent with a prognostic expectation of more than 10 years (vs <5 years) were less inclined to proclaim documentation of a surrogate decision-maker and treatment preferences and to consider luxury over life extension and were more prone to want cardiopulmonary resuscitation and mechanical ventilation, in analyses adjusted for individual characteristics. A similar correlation among the respondents who reported that they were not sure about prognosis was discovered. Hence, in subjects undergoing dialysis, uncertain and overly optimistic prognostic expectations could restrict the advantage of advance care planning and add to high-intensity end-of-life care.