Posted: December 14, 2022

When we think about kidney disease and care, the focus is often on dialysis treatment. However, there is an increasing recognition that dialysis does not benefit everyone, particularly elderly patients with chronic kidney disease (CKD).

Grand River Hospital’s Multi-Care Kidney Clinic uses an approach known as conservative renal care as an alternative to dialysis for some patients. This is an active management approach, aimed at delaying CKD progression, minimizing the risk of adverse events and complications, and relieving symptoms - without using dialysis.

The clinic takes a person-centred approach, working collaboratively with patients, families, and caregivers to identify goals of care and support patients and families in the care journey. Care usually involves treatments like medication and recommendations for exercise, diet, and daily activities. This allows patients to avoid the negative aspects of dialysis (for example, the time required), improving their quality of life.

GRH nurse practitioner Steve Gobran and nephrologist (kidney doctor) Michael Wang presented two workshops on the topic of conservative renal care at the annual conference for Long Term Care Clinicians this fall. They discussed what conservative renal care is, why it’s beneficial, and how the GRH Multi-Care Kidney Clinic works together with local Long Term Care facilities to support patients and families who choose for conservative renal care instead of dialysis.

“We had some great reviews from conference participants,” says Steve. “Participants told us they were happy to see a refreshing take on caring for the elderly with chronic kidney disease. We were able to discuss patient quality of life considerations, and what this decision might look like for the patient.”

Steve and Dr. Wang hope that after participating in this workshop, more long term care clinicians will be equipped to support patients who chose conservative renal care instead of dialysis.

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