Kidney Size Reduction CKD Chronicity — ESENeph MCQ

Correct answer: E — Respect the informed decision and coordinate conservative end-of-life care

The best answer is “Respect the informed decision and coordinate conservative end-of-life care”. NICE supports shared decision-making about switching or stopping kidney replacement therapy and coordinated management of symptoms, medications, place of care and family support. “Continue dialysis while reassessing capacity, symptoms and treatment burden” is less appropriate because a capacitous patient may refuse or stop treatment “Include family perspectives while preserving the patient’s decision-making authority” is less appropriate because family input does not replace the patient’s capacitous decision “Continue active symptom treatment after dialysis withdrawal” is less appropriate because active conservative and palliative management remains essential “Seek legal review when capacity or best interests remain disputed” is less appropriate because routine valid refusal does not require court authorization

Reference: NICE NG107: renal replacement therapy and conservative management: https://www.nice.org.uk/guidance/ng107/chapter/Recommendations