ASN Kidney Health Guidance on Conservative Management in People with Kidney Failure

KEY POINTS: Conservative management is customized CKD care, symptom management, and support to navigate care across the CKD trajectory through end of life. Conservative management is defined by shared decision-making and interdisciplinary teamwork in alliance with patients and care partners. Implementation of conservative management hinges on each practice's logistical considerations and resource availability. Conservative management is holistic and whole-person care for people with kidney failure. This care pathway is often a good choice for patients who prioritize independence, quality of life, and avoidance of burdens associated with life-prolonging therapies such as dialysis. This Kidney Health Guidance aims to provide evidence-based clinical guidance to promote best practices in conservative management care delivery. Conservative management comprises three components, including customized CKD care, symptom management, and smooth navigation of care transitions. This Kidney Health Guidance describes the application of these three components across the illness trajectory, including the role of shared decision-making, care partner engagement, and interdisciplinary collaboration. Practical strategies are outlined for health care professionals to integrate conservative management care delivery into practice. PODCAST: This article contains a podcast at https://dts.podtrac.com/redirect.mp3//www.asn-online.org/media/podcast/JASN/2026_03_18_KTS_March2026.mp3.