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Conservative Management — ESENeph MCQ

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ModerateChronic Kidney DiseaseConservative ManagementESENeph

A 72-year-old woman with CKD G5 (eGFR 8 mL/min/1.73m2) has decided against dialysis after informed shared decision-making. She wishes for conservative management. What key elements should be included in her care plan?

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Correct answer: E — Symptom management, advance care planning, renal supportive care, and community palliative care involvement

NICE NG107 and UKKA conservative management pathway emphasise symptom management (nausea, itch, pain, breathlessness), advance care planning (including DNACPR and preferred place of care/death discussion), renal supportive care integration, and community palliative care involvement. Monitoring should focus on symptoms and quality of life rather than biochemistry. Dietary advice should be pragmatic and personalised, not restrictively prescriptive.

Reference: NICE NG107 2018 – RRT and Conservative Management; UKKA 2021 – Conservative Kidney Management