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Conservative Kidney Management Survival — SCE Palliative Medicine MCQ

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ModerateNon-Malignant Palliative CareConservative Kidney Management SurvivalSCE Palliative Medicine

A 70‑year‑old man with end‑stage renal disease on conservative management asks about typical survival without dialysis. His eGFR is 8 ml/min/1.73 m² and declining. What should he be told?

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Correct answer: E — Median survival on conservative management with eGFR <10 is about 6–12 months, but individual variation is wide—factors such as age, comorbidity and rate of decline affect it

Option E is correct. It reflects the systematic review data showing median survival on conservative management in the range of approximately 6–31 months, with many patients around 6–12 months, and emphasises prognostic heterogeneity, which is essential in shared decision‑making. Option C is incorrect—dialysis often offers longer survival in fitter patients. Option A is not supported—10+ years is not typical. Option B is clearly false—survival is measured in months, not hours. Option D is unhelpful and inaccurate—while prognostication is imprecise, reasonable estimates are possible and important for planning.

Reference: Voorend et al., "Survival of patients who opt for dialysis versus conservative care: a systematic review and meta‑analysis", Nephrol Dial Transplant, 2022 (provides unadjusted median survival for conservative management: 6–31 months)