DOI: 10.1146/annurev-med-042425-022821 ISSN: 0066-4219
Conservative Management of Kidney Failure
Jordana Yahr, Jane O. Schell, Samantha L. GelfandThe default therapy for end-stage kidney disease is often dialysis, but for those with advanced age and multimorbidity, it may not provide significant benefit to longevity or quality of life. Conservative management (CM) is a holistic care pathway for those whose care preferences do not align with dialysis. CM aims to optimize quality of life over the disease course as patient priorities evolve and their disease progresses. Components of CM include customized chronic kidney disease care, symptom management, and navigation of transitions of care, including end-of-life care. Nephrology clinicians are the central providers of CM and ideally collaborate with a multidisciplinary team to provide medical, psychosocial, and spiritual care.