LAUSR

Abstract The number of patients given renal replacement therapy (RRT) has expanded significantly over the last few decades, but it is increasingly recognized that such invasive treatment might not offer the intended and desired quality of life for very frail, elderly people and those with multiple co-morbidities. Comprehensive conservative care is an increasingly accepted and recognized way to provide viable, high-quality treatment for patients with advanced chronic kidney disease (CKD) who are unlikely to benefit from or choose not to have RRT. Comprehensive conservative care comprises interventions to delay progression of CKD and mitigate associated risks and complications, active managements of symptoms, shared decision-making, advance care-planning and psychosocial and family support. Use of symptom assessment tools is encouraged in clinical practice as a way to measure symptom burden and focus efforts on what matters to patients and their caregivers.