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Integrated kidney care requires synergistic linkage between preventative care for people at risk for chronic kidney disease and health services providing care for people with kidney disease, ensuring holistic and coordinated care as people transition between acute and chronic kidney disease and the 3 modalities of kidney failure management: conservative kidney management, transplantation, and dialysis. People with kidney failure have many supportive care needs throughout their illness, regardless of treatment modality. Kidney supportive care is therefore a vital part of this integrated framework, but is nonexistent, poorly developed, and/or poorly integrated with kidney care in many settings, especially in low- and middle-income countries. To address this, the International Society of Nephrology has (i) coordinated the development of consensus definitions of conservative kidney management and kidney supportive care to promote international understanding and awareness of these active treatments; and (ii) identified key considerations for the development and expansion of conservative kidney management and kidney supportive care programs, especially in low resource settings, where access to kidney replacement therapy is restricted or not available. This article presents the definitions for conservative kidney management and kidney supportive care; describes their core components with some illustrative examples to highlight key points; and describes some of the additional considerations for delivering conservative kidney management and kidney supportive care in low resource settings. Integrated kidney care requires synergistic linkage between preventative care for people at risk for chronic kidney disease and health services providing care for people with kidney disease, ensuring holistic and coordinated care as people transition between acute and chronic kidney disease and the 3 modalities of kidney failure management: conservative kidney management, transplantation, and dialysis. People with kidney failure have many supportive care needs throughout their illness, regardless of treatment modality. Kidney supportive care is therefore a vital part of this integrated framework, but is nonexistent, poorly developed, and/or poorly integrated with kidney care in many settings, especially in low- and middle-income countries. To address this, the International Society of Nephrology has (i) coordinated the development of consensus definitions of conservative kidney management and kidney supportive care to promote international understanding and awareness of these active treatments; and (ii) identified key considerations for the development and expansion of conservative kidney management and kidney supportive care programs, especially in low resource settings, where access to kidney replacement therapy is restricted or not available. This article presents the definitions for conservative kidney management and kidney supportive care; describes their core components with some illustrative examples to highlight key points; and describes some of the additional considerations for delivering conservative kidney management and kidney supportive care in low resource settings. As part of its focus on integrated care of people with kidney failure, the International Society of Nephrology (ISN) brought together patients with kidney failure, health care professionals, researchers, academic and health care institutions, and policy makers to formulate a 5- to 10-year strategy to improve global access to safe, sustainable, and equitable integrated care for people with kidney failure. “Integrated kidney care” requires synergistic linkage between preventative care for people at risk for chronic kidney disease and health services providing care for people with kidney disease, ensuring holistic and coordinated care as people transition between acute and chronic kidney disease and the 3 modalities of kidney failure management: conservative kidney management (CKM), transplantation, and dialysis.1Harris D.C.H. Davies S.J. Finkelstein F.O. et al.Increasing access to integrated ESKD care as part of universal health coverage.Kidney Int. 2019; 95: S1-S33Abstract Full Text Full Text PDF PubMed Scopus (102) Google Scholar People with kidney failure have many supportive care needs throughout their illness; kidney supportive care (KSC) is therefore a vital part of this integrated framework to address these needs regardless of treatment modality. Action plans were categorized into 5 themes and workgroups: monitor, dialysis, resources, transplantation, and conservative kidney management and kidney supportive care.2Harris D.C.H. Davies S.J. Finkelstein F.O. et al.Strategic plan for integrated care of patients with kidney failure.Kidney Int. 2020; 98: S117-S134Abstract Full Text Full Text PDF PubMed Google Scholar The aim of the CKM/KSC Workgroup is to define key considerations for the development and expansion of CKM and KSC as core components of integrated kidney care. This will involve identification of countries with no or limited services and training programs and development of materials and pathways for implementation of sustainable CKM and KSC programs. Through a series of consensus meetings, the workgroup will perform its activities within 4 projects that have been revised since the initial publication of the strategic plan, outlined in Box 1.2Harris D.C.H. Davies S.J. Finkelstein F.O. et al.Strategic plan for integrated care of patients with kidney failure.Kidney Int. 2020; 98: S117-S134Abstract Full Text Full Text PDF PubMed Google Scholar,3Bello A.K. Levin A. Lunney M. et al.Status of care for end stage kidney disease in countries and regions worldwide: international cross sectional survey.BMJ (Clin Res ed). 2019; 367: l5873Crossref PubMed Scopus (0) Google Scholar Progress with these initial projects will define the direction of future activities.Box 1Activities of the ISN Conservative Kidney Management/Kidney Supportive Care Workgroup within the 5- to 10-year strategic plan for integrated care of people with kidney failure2Harris D.C.H. Davies S.J. Finkelstein F.O. et al.Strategic plan for integrated care of patients with kidney failure.Kidney Int. 2020; 98: S117-S134Abstract Full Text Full Text PDF PubMed Google ScholarTabled 1Project 1: Define and identify the core components of conservative kidney management and kidney supportive care to promote international understanding, awareness, and development.Project 2: Undertake an updated environmental scan of existing conservative kidney management programs (as part of the Global Kidney Health Atlas initiative)3Bello A.K. Levin A. Lunney M. et al.Status of care for end stage kidney disease in countries and regions worldwide: international cross sectional survey.BMJ (Clin Res ed). 2019; 367: l5873Crossref PubMed Scopus (0) Google Scholar that incorporates fully the considerations and elements in project 1.Project 3: Disseminate prognostic tools and information for patients and health care providers about the range of clinical outcomes of importance to people considering conservative kidney management.Project 4: Develop a global ISN (core) curriculum for conservative kidney management and kidney supportive care to promote training in these fields.Project 5: Support the development of conservative kidney management programs in places where they do not currently exist, particularly for low- and low middle-income countries. Open table in a new tab ISN, International Society of Nephrology. Tabled 1Project 1: Define and identify the core components of conservative kidney management and kidney supportive care to promote international understanding, awareness, and development.Project 2: Undertake an updated environmental scan of existing conservative kidney management programs (as part of the Global Kidney Health Atlas initiative)3Bello A.K. Levin A. Lunney M. et al.Status of care for end stage kidney disease in countries and regions worldwide: international cross sectional survey.BMJ (Clin Res ed). 2019; 367: l5873Crossref PubMed Scopus (0) Google Scholar that incorporates fully the considerations and elements in project 1.Project 3: Disseminate prognostic tools and information for patients and health care providers about the range of clinical outcomes of importance to people considering conservative kidney management.Project 4: Develop a global ISN (core) curriculum for conservative kidney management and kidney supportive care to promote training in these fields.Project 5: Support the development of conservative kidney management programs in places where they do not currently exist, particularly for low- and low middle-income countries. Open table in a new tab ISN, International Society of Nephrology. This article is the first deliverable for project 1, aimed at improving and standardizing descriptions of CKM and KSC; improving communication by stakeholders; promoting acceptance of CKM as a treatment for kidney failure; and promoting KSC as a core component of nephrology. Although we considered global issues across low- or middle-income countries (LMICs) and high-income countries, we prioritized LMICs and vulnerable populations in all countries. The specific goals of this article are to (i) define acceptable terminology to promote international understanding and awareness of CKM and KSC; (ii) describe key components of CKM and KSC; and (iii) discuss some key considerations for the development and expansion of CKM and KSC as core components of integrated care for people with kidney failure.4Davison S.N. on behalf of the Kidney Supportive Care Research GroupConservative kidney management care pathway.https://www.ckmcare.com/Date accessed: June 27, 2023Google Scholar, 5St. George Hospital and Community Health Services: renal supportive care.https://stgrenal.org.au/renal-supportivecareDate accessed: June 27, 2023Google Scholar, 6Brown M.A. Crail S.M. Masterson R. et al.ANZSN Renal Supportive Care Guidelines 2013.Nephrology. 2013; 18: 401-454Crossref PubMed Scopus (59) Google Scholar, 7Davison S.N. Levin A. Moss A.H. et al.Executive of the on Supportive Care in Kidney a to improving Int. 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Davison et al. (Mon,) studied this question.