Conservative Management in Kidney Disease If you would like to discuss your kidney diagnosis with our trained members of staff, ring the free to call number 0800 169 0936. The NKF Helpline is available Monday to Thursday 08:30am - 5:00pm Friday 9.00am – 1.00pm on 0800 169 09 36 or email [email protected]. It is important for people with advanced Chronic Kidney Disease (CKD) What if I think dialysis is not the right choice for me? You have the right to decide not to start dialysis if you feel that the burden of the treatment would outweigh the benefits, and so reduce your quality of life. Deciding not to have dialysis does not mean you will have no treatment for your CKD. We call this (no dialysis) option conservative care. Why might I choose not to have dialysis? For many people with advanced CKD, dialysis treatment (or a kidney transplant) means that they can still have a fulfilling life. There isn’t a cure for CKD and dialysis treatment doesn’t always: • improve other health problems• improve quality of life• extend life Dialysis treatment can be demanding on your time and energy, and most people need to make changes to their lifestyle (such as diet and fluid intake). Some types of dialysis also involve spending a lot of time at hospital. What is conservative care? The aim of treatment with conservative care is your wellbeing and quality of life. Conservative care (also called supportive care) aims to: • treat and reduce any physical symptoms of CKD such as:– tiredness– feeling sick– itching– swelling and breathlessness • protect and maintain any remaining kidney function (where possible) by:– controlling your blood pressure– changes to your diet– changes to your medication • provide emotional, social and spiritual support• plan for the future Your care will be shared between the Renal Unit, your GP and community services you may need. You will be seen in clinic, or have an appointment by telephone or video call, by a doctor and/or a specialist nurse, who will see you as little or as often as needed. The nurse specialist for supportive care will support you and your family at home and liaise with other services you may need. If I don’t dialyse will I die sooner? How long someone lives is different for each person and will depend on: • existing medical conditions• amount of kidney function left Not having dialysis may shorten your life but for some people dialysis could worsen their quality of life. If your doctor thinks you are not well enough to start dialysis and it will shorten your life, they will explain this to you. The renal team will be supportive whatever you decide. Who can I talk with to help me make a decision? Many people find it hard to talk about deciding not to have dialysis. They are often concerned that they will upset their relatives or are worried how they will react. As with anything that is difficult, it is always best to talk openly and honestly. Your clinic doctors and the pre-treatment nurses will be happy to discuss the options with you, and those close to you if you wish. Often people find it helpful to have a friend or family member present for these discussions. Some people also find it helpful to speak with their family doctor or their religious advisor, for example. Can I change my mind? You can change your mind and your kidney doctor and the renal team will support you. You need to be aware however, that starting dialysis in an unplanned way can be difficult and if you start treatment very late, it can be harder on your body. Further planning Some people take the opportunity to think further about their preferences for what they would want for the future if, or when, their health worsens. This is called Advanced Care Planning. If you would like to think more about your preferences please let your hospital know. If you have already written an advanced directive (or ‘living will’) please:• Let staff at your Renal Unit know about this• Talk with your family, friends and carers about this, so that they know your wishes as well. Last reviewed January 2022Next review January 2025 Download this Information in PDF The National Kidney Federation cannot accept responsibility for information provided. The above is for guidance only. Patients are advised to seek further information from their own doctor.