Tell me a little about who's deciding — their age, other health conditions, and what the kidney team has said. I'll lay the two paths next to each other in plain words, plus the four questions to bring to the kidney appointment, so the biggest decision of a life isn't made by default.
A preparation scaffold built on Kidney Health Australia and Better Health Channel guidance. It doesn't tell you which path to choose — only your treating kidney team can do that with you. Built for adult kidney decisions.
This tool helps you prepare — it can't tell if something is urgent. If you're worried right now, call 000 or your kidney team.
The two paths, side by side
| What we're comparing | Dialysis(haemodialysis / peritoneal) | Comprehensive conservative care |
|---|---|---|
| What it is | A machine does the kidneys' filtering job | Active medical care without dialysis — symptom control, not artificial life extension |
| Time it takes | Haemodialysis: usually 3 sessions/week, ~4–5 hours each, often at a unit | Built around your normal life; clinic + home support |
| Where | Dialysis unit (or home, for some) | Mostly home / community, GP + kidney team |
| Aim | Replace kidney function, extend life | Keep you comfortable, protect quality of life |
| Trade-off | More medicalised time; treatment burden | Fewer interventions; symptom-led |
Haemodialysis schedule (3×/week, ~4–5 hr/session) per Better Health Channel / Kidney Health Australia. Conservative care, in Kidney Health Australia's own words, “aims to keep you comfortable and provide a reasonable quality of life, while not artificially extending your life” (Kidney Health Australia).
This grid shows the two paths — it doesn't score or rank them. You weigh what fits.
The four questions to bring to the kidney team
Tick each one off as you ask it. Leave room to write down their answers.
The survival numbers above are averages from groups of people — they cannot tell you how long you'll live, and individuals vary widely. Conservative care is not “giving up” or “doing nothing” — it is active medical care. And dialysis is not automatically the path to more good-quality time, especially with frailty, heart disease or dementia in the picture. Some people who start dialysis later wish they'd understood the day-to-day burden first; some who chose conservative care live well for years. There is no universally right answer here — only the one that's right for this person's body and what they value.
Quality-of-life and symptom-burden picture: conservative care may have advantages for some on quality of life, hospitalisation and place of death (Cochrane review summary; systematic review, PMC8434727).
One page: both paths side by side, the four questions to ask, room to write the team's answers.
This is the general version. The full Kidney Decisions kit walks through dialysis types, transplant, and conservative care for your exact situation — with the questions, the numbers, and a values worksheet to do with your family.
More at drhblo.com/learn/kidney-decisions
After the appointment, capture what the team said while it's fresh. The Post-Consult Debrief →