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Conservative management for kidney failure: care without dialysis, your right to decide, the care team, hospice, food, and how you may feel
For adults whose kidneys are failing who are thinking about care without dialysis or a transplant, and the family and friends helping them. It passes on, by name, what the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK, part of the NIH) says: what conservative management is and its other names; that you have the right to decide how your kidney failure is treated; what the care plan includes and who is on the team; who may choose it, and when dialysis may not help; hospice, and that Medicare covers it; food; how you may feel; and NIDDK’s honest answer about how long. It builds the questions to ask and prints a care card. It does not tell you what to choose. Nothing is saved.
A word with a dotted line under it, like this, opens its official definition, quoted from a U.S. government glossary.
Right now
- Trouble breathing, chest pain, or someone who cannot be woken? Call 911 (ours). If the person is in hospice, the hospice team will also tell you who to call.
- Thoughts of suicide, or all too much? Call or text 988, any hour, free, for the person who is ill or for the family (ours).
- A new symptom, or one that is getting worse? Call your care team; that is what they are there for (ours).
- You do not have to decide today, or alone. NIDDK says the choice is yours, and your team can help you understand your health.
More help
- Kidneys on this site: Kidney failure: choosing a treatment · When it’s your kidneys · Eating with kidney disease · Anemia in kidney disease · Paying for kidney failure treatment · Kidneys, bladder and urine: find the right page.
- Near the end of life: When someone you love is dying · Caring for someone · When someone has died.
- For you: Get ready for your appointment. In an emergency: Help right now (988, 911). All our free tools.
Kidneys, bladder or urine, and not sure this is the right page? The pages on this site for bladder infections, kidney stones, blood in the urine, bladder pain, bladder leaks, the prostate, kidney disease and bedwetting, on one list.
This page and its wording were written with AI (Claude) for Scarlet Beast (our AI policy). No doctor, nurse or social worker has reviewed it. The facts were read on October 21, 2026 on NIDDK’s (NIH) page Conservative Management for Kidney Failure and its Spanish version, Tratamiento conservador para la insuficiencia renal, both last reviewed in January 2018. We link Medicare’s Hospice Care Coverage page as NIDDK does, and say nothing about it beyond NIDDK’s line that Medicare covers hospice care. Ours: the 911 and 988 lines; that choosing your care is different from wanting to die; that you do not have to decide today or alone; calling your team about a new symptom; asking what happens if you change your mind (a question, not a promise); asking for help putting your wishes in writing; the questions to ask; the card; the links to our other pages; and the order of the steps. What we left out: the hospice PDF NIDDK links to (from another organization; we did not read it), NIDDK’s two references, and its other kidney failure pages, which our page Kidney failure: choosing a treatment draws on. Nothing you tick or type here is saved or sent.