Conservative Approach

Conservative Approach

Reaching the academic and insurance-approved guidelines to start dialysis, and meeting the eGFR (a measure of kidney function percentage) to receive the diagnosis of renal failure or end-stage renal disease (ESRD), are not sufficient reasons to enter the world of dialysis.

Certainly, there is plenty of medical literature supporting the immediate start of dialysis upon reaching these milestones, but the literature fails to consider the unique individual, namely, you. Personal preferences, lifestyle, overall health, other illnesses, social support, etc., are all critical factors that should influence the decision to start dialysis, thus choosing conservative approach.

If you have reached the milestone where dialysis is needed, the first thing you need to do is STOP, take a breath, and talk to yourself first. You should also consult your primary care provider, nephrologist, and all individuals involved in your care and support. Additionally, it’s crucial to visit a dialysis center, speak with staff and a patient you know personally, and ask plenty of questions. After evaluating your options and having all your questions answered, you should STOP AGAIN, talk to yourself, and make a decision. Ultimately, the decision you make is the best one for YOURSELF because no one knows you better than you

WHAT HAPPENS TO ME IF I CHOOSE NOT TO START DIALYSIS

The role of Palliative Medicine in the Initiation and Withdrawal from Dialysis

Nobody should have any authority to order you to follow a certain approach. THIS IS YOUR LIFE.

Basically, it is up to you to decide which treatment option is the best fit for your individual needs and priorities. Reading up on your options and discussing them with your healthcare team, family, and friends is a good way to make an informed decision. However, if you find that your initial choice isn’t working for you, you can always switch to a different treatment option.

In some rare cases a conservative approach is preferred, where patients may choose to forgo kidney replacement therapy altogether and opt for conservative approach  with palliative care only.