Conservative Kidney Management and kidney Supportive Care: Essential Treatments for Kidney Failure

Kidney supportive care (KSC) and conservative kidney management (CKM) are essential treatments for kidney failure (KF) but are nonexistent, poorly developed, and/or poorly integrated with kidney care across low-, middle-, and high-income countries. This article reviews the updated definitions and evidence for KSC and CKM and discusses who will most benefit from these treatments. Conservative kidney management involves highly individualized active treatment that comes with its own set of recommendations that focus predominantly on patient-specific goals and health-related quality of life. The recommendations for managing the complications of kidney failure and the symptoms of pain, restless legs, uremic pruritus, nausea and vomiting, poor sleep and fatigue, and breathlessness in people receiving CKM are reviewed. Additional considerations for delivering CKM in low resource settings are discussed.