Good quality information is lacking about how patients die. This is particularly true for chronic kidney disease (CKD) patients who have extensive and unique end-of-life care considerations and needs. Research specific to CKD is required to develop systematic and comprehensive information on the end-of-life care needs and the quality of end-of-life care for patients with CKD, to describe the effectiveness of existing end-of-life care strategies in CKD (including cost-effectiveness), to identify areas that should be priorities for improvement and ultimately to develop innovative strategies for improving the end-of-life care for patients dying with CKD. This paper will highlight the challenges and limitations of the current approaches to end-of-life care research and will outline what is required, both in content and methodology, to move the field of renal palliative care forward.