Objective  Systematic evaluation of the effectiveness of patient decision aids on decision-making for renal replacement therapy in patients with chronic kidney disease.  Methods  Computerized searches for Web of Science, PubMed, Cochrane Library, Embase, China Knowledge, and Wanfang databases were conducted to obtain literature about decision aids for chronic kidney disease, with a timeframe from the time of construction to December 2023. Data were analyzed using Review Manager 5.4 software.  Results  A total of 12 articles were obtained. Analyses of the articles showed that the use of decision aids can increase patients' decision knowledge (MD=2.29, 95% CI: 1.18～3.39, P<0.001), reduce patients' decision conflict (MD=−0.69, 95% CI: −1.09～−0.29, P<0.001), and improve decision quality.  Conclusion  Decision aids can improve patients' decision-making behavior and enhance decision-making quality. Further studies are needed to assess the assistant effectiveness of decision-making for renal replacement therapy.