What is conservative care for kidney disease?
Learn about ways to manage your kidney disease symptoms without dialysis or a transplant.
You may find that a care plan that does not include dialysis or transplant may be the best option for you.
Choosing conservative care
Conservative care focuses on managing kidney disease symptoms without dialysis or transplant. Earlier in your CKD journey, this will likely be exactly like the usual treatment you get from your kidney doctor. If your kidney disease progresses and becomes severe, palliative care and/or hospice will be needed to help you stay comfortable at home and maintain your quality of life.
For some people, dialysis may not improve their kidney failure symptoms and could worsen quality of life rather than improve it. People who may not benefit from dialysis include those who have:
- End-stage heart failure
- End-stage lung failure
- Terminal cancer
- Debilitation or dementia
Getting the support you need
If you feel that dialysis is not the right choice for you, share your feelings honestly with your friends and family. Help them understand why conservative care is important to you.
Talk to your care team
Your care team can help you understand your life expectancy and how to make the best decision for you. You can discuss:
- The option that will give you the best quality of life
- The pros and cons of dialysis treatment
- Your wishes about treatment for your kidney failure
- How dialysis treatment may impact your overall health and any other health conditions
If you choose conservative care
Make your friends and family aware of your choice. You should complete advance directives, including a living will and a durable healthcare power of attorney, in case you become sick or the unexpected happens.
Some people who choose conservative care meet resistance in healthcare settings due to lack of understanding. Talk to your nephrologist, palliative care team, or hospice team about how to handle this.
If you change your mind
It is your right to change your mind about treatment at any time. If you want to start dialysis, discuss that with your nephrologist right away. Changing your mind late in your disease may be difficult or unsafe and could lead to complications.
Key takeaways
- Dialysis may not be the best option for everyone, including people with other serious illnesses.
- Conservative care manages kidney disease symptoms without dialysis or a transplant, with palliative or hospice care available if the disease becomes severe.
- Your care team can help you understand your options and make the best decision for you.
- Complete advance directives, like a living will and healthcare power of attorney, and make sure your friends and family know your wishes.
- You can change your mind about treatment at any time by discussing your options with your kidney doctor.
We are here to help
Your care team is here to support you along the way while respecting your healthcare wishes.
This serves only as a guide. Talk with your healthcare provider for more information based on your health needs.
Julie Dominguez, MD
Vice President, Medical Office, Interwell Health
Julie Dominguez, MD, is a nephrologist with extensive experience in private practice nephrology and medical education. At Interwell Health, she helps advance high-quality kidney care programs that support patients and clinicians. Dr. Dominguez earned her medical degree from the University of Texas Southwestern Medical Center, completed her Internal Medicine residency at Duke University, and completed her Nephrology fellowship at the University of California San Diego.