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During the congress, E-Posters will be accessible to all participants on the congress website 24/7, as well as in the E-poster stations in the congress center.
Preparing your E-Poster
Please review the E-Poster format requirements carefully when preparing your E-Poster. Should your E-Poster not meet the mentioned requirements, it may not be displayed as described above.
E-Poster Submission Deadline
Please prepare and upload your E-Poster no later than March 14, 2026 11.59PM CET. After this date, you will no longer be able to prepare and upload your E-poster and it will not be displayed and accessible on the congress website.
Please follow the instructions below to input your abstract title.
Abstract titles should be brief and reflect the content of the abstract.
Conservative kidney management (CKM) has emerged as a patient-centered alternative to dialysis for elderly and frail individuals with advanced chronic kidney disease (CKD). In rural and suburban communities — where geographic barriers and limited resources accentuate the burdens of in-center dialysis for some patients — CKM may better align with patients’ preferences and quality-of-life goals.
We conducted a retrospective review of shared decision-making consultations about choice of treatment for ESKD at a Nephrology centre serving predominantly rural and suburban populations, between January 2022 and December 2023. We collected demographic and clinical data— including age, gender, Charlson Comorbidity Index (CCI), Clinical Frailty Scale (CFS), autonomy and living situation — and documented intervals from counseling to first CKM clinic. We tracked patient-centered outcomes: survival time; place of care and death; and utilization of home-based, palliative, and community services. Comparisons with contemporaneous dialysis patients considered differences in age, comorbidity and frailty. Comparisons with dialysis patients were made using non-parametric tests.
Among 208 evaluated patients, 27 (13%) opted for CKM. The median age was 88 years (IQR 86–89.5), the median CCI was 8, and the median CFS was 6 (“Moderately to Severely Frail”), reflecting a high burden of comorbidity and frailty. Most patients lived at home (81%), predominantly in rural or suburban areas, while 19% resided in nursing facilities. Sixteen CKM patients (59%) attended the dedicated CKM clinic, while others continued general nephrology follow-up. The median interval from counseling to CKM clinic visit was 3.5 months (IQR 3–4), reflecting proactive coordination of care across dispersed settings. Over follow-up, nine patients (33%) died — three before their first clinic appointment. Among those seen in the CKM program, median post–first-visit survival was 9.5 months (IQR 4.5–12.2; range 0–14.5). Deaths were attributed to acute intercurrent illnesses (44%), CKD progression (33%), or unclassified causes (22%), with two-thirds occurring in hospital and one-third under home-based palliative care. Compared to 181 dialysis patients, CKM patients were significantly older, more comorbid, and frailer (all p <0.001).
Patients opting for CKM are typically elderly, frail, and highly comorbid. Most deaths were not directly attributable to terminal CKD but to acute intercurrent events. These findings emphasize that CKM represents a deliberate and appropriate clinical choice rather than therapeutic omission, underscoring the need for structured, multidisciplinary programs integrating palliative care and community-based support. Such programs should prioritize holistic well-being and ensure alignment with available resources in non-urban settings.
