Patients have a fundamental right to be involved in making decisions that affect their health care treatment and outcomes. Patients need to be knowledgeable about disease process and treatment options to exercise this right. The National Kidney Foundation-Dialysis Outcomes Quality Initiative (NKF-DOQI) Clinical Practice Guidelines on Hemodialysis Adequacy, Peritoneal Dialysis Adequacy, Treatment of Anemia of Chronic Renal Failure, and Vascular Access, introduced in 1997, include new clinical recommendations that may impact patient treatment choices. Access to these guidelines presents a unique professional opportunity to empower patients through education related to NKF-DOQI. This article highlights the role of patients in implementing NKF-DOQI in light of studies conducted by two renal patient organizations, the National Kidney Foundation (NKF) and the American Association of Kidney Patients (AAKP). Results from the AAKP survey indicate that end-stage renal disease patients are willing to change behavior to feel better and live longer. Results from the NKF focus study show that dialysis patients need to receive information about NKF-DOQI and understand its direct impact on patient outcomes. In addition, results from both studies reveal that patients feel strongly about participating in health care decisions that impact on their treatment and outcomes.