Conservative management of patients with end-stage kidney disease

Nurs Stand. 2020 Jun 3;35(6):43-50. doi: 10.7748/ns.2019.e11416. Epub 2019 Dec 23.


The prevalence of end-stage kidney disease is increasing, particularly among older people and those with multiple comorbidities. Typically, patients who develop end-stage kidney disease receive renal replacement therapies such as dialysis; however, this treatment can significantly affect quality of life and may not prolong life in older patients. Therefore, some patients may choose not to undergo dialysis and instead choose conservative management, which involves a palliative approach that focuses on maintaining quality of life and advance care planning. This article details the steps involved in a conservative kidney management pathway for end-stage kidney disease, including symptom management and advance care planning. It also discusses the importance of a palliative approach for patients receiving dialysis.

Keywords: advance care planning; end of life care; nursing care; palliative care; signs and symptoms; symptom management.

MeSH terms

  • Advance Care Planning*
  • Aged
  • Conservative Treatment
  • Humans
  • Kidney Failure, Chronic* / therapy
  • Palliative Care
  • Quality of Life
  • Renal Dialysis