Why you should read this article:

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To enhance your awareness of the symptoms that patients with end-stage kidney disease may experience

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To understand what conservative management of patients with end-stage kidney disease entails, including symptom management and advanced care planning

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To count towards revalidation as part of your 35 hours of CPD, or you may wish to write a reflective account (UK readers)

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To contribute towards your professional development and local registration renewal requirements (non-UK readers)

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.