Indian Journal of Palliative Care
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Year : 2021  |  Volume : 27  |  Issue : 5  |  Page : 11--13

Comprehensive conservative care in end-stage kidney disease

1 MNJ Institute of Oncology and Regional Cancer Centre; Pain Relief and Palliative Care Society; INCTR Canada Palliative Access (PAX) Program India, MNJ Institute, Hyderabad, Telangana, India
2 Department of Nephrology, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal, Karnataka, India
3 Department of Renal Replacement Therapy and Dialysis Technology, Manipal College of Health Professions, Manipal Academy of Higher Education, Manipal, Karnataka, India
4 Department of Nephrology, SVIMS, Tirupathi, Andhra Pradesh, India

Correspondence Address:
Srinivas Vinayak Shenoy
Department of Nephrology, Kasturba Medical College Manipal, Manipal Academy of Higher Education (MAHE), Manipal, Karnataka
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/ijpc.ijpc_63_21

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In patients with end-stage kidney disease (ESKD), when there maybe situations where dialysis does not offer benefits in terms of survival or health-related quality of life, dialysis should not be viewed as the default therapy. Such patients can be offered comprehensive conservative care as an alternative to dialysis. Conservative (nondialytic) management of ESKD includes careful attention to fluid balance, treatment of anemia, correction of acidosis and hyperkalemia, blood pressure, and calcium/phosphorus metabolism management and dietary modification. Individualized symptom management and supportive care are crucial to maximize the quality of life. We propose that model of comprehensive conservative care in ESKD should manage both diseases as well as provide supportive care. Facilitating implementation of comprehensive conservative care requires coordination between nephrology and palliative care at patient, professional, administrative, and social levels to maximize benefit with the motto to improve the overall quality of life.


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