The Evolution of Conservative Care in Portugal: From Ethical Foundations to Systematic Implementation

Authors

  • Ana Farinha Department of Nephrology, Unidade Local de Saúde (ULS) Arrábida, Setúbal, Portugal; ICBAS ‑ School of Medicine and Biomedical Sciences, University of Porto, Porto, Portugal https://orcid.org/0000-0002-5402-7626

DOI:

https://doi.org/10.71749/pkj.151

Keywords:

Kidney Failure, Chronic, Nephrology, Palliative Care, Practice Patterns, Physicians

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References

Davison SN, Levin A, Moss AH, Jha V, Brown EA, Brennan F, et al. Executive summary of the KDIGO Controversies Conference on Supportive Care in Chronic Kidney Disease: developing a roadmap to improving quality care. Kidney Int. 2015;88:447-59. doi:10.1038/KI.2015.1102.

Farinha A, Farinha A, Branco A, Mateus A, Martins AR, Marques da Costa B, et al. Conservative Care Consensus Document Portuguese Society of Nephrology Conservative Care Working Group. PKJ Port Kidney J. 2024;38:1-23. doi:10.71749/pkj.272.

Direção-Geral da Saúde. Norma 17 [Accessed May 22, 2023]. Available at: https://www.dgs.pt/directrizes-da-dgs/normas-e-circulares-normativas/norma-n-0172011-de-28092011-atualizada-a-14062012-jpg.aspx

Farinha A, Valério P, Borges L, Lourenço A. Supportive Care Program in CKD: from dream to reality. Port J Nephrol Hyper. 2021;35:219-23. doi:10.32932/pjnh.2021.12.153

Sociedade Portuguesa de Nefrologia. Registro SPN [Accessed April 17, 2025]. Available at: https://www.spnefro.pt/assets/relatorios/tratamento_doenca_terminal/apresentacao-dmr-2025-(2).pdf

Roderick P, Rayner H, Tonkin-Crine S, Okamoto I, Eyles C, Leydon G, et al. A national study of practice patterns in UK renal units in the use of dialysis and conservative kidney management to treat people aged 75 years and over with chronic kidney failure. Southampton: NIHR Journals Library; 2015.

Stel VS, de Jong RW, Kramer A, Andrusey AM, Baltar JM, Barbullushi M, et al. Supplemented ERA-EDTA Registry data evaluated the frequency of dialysis, kidney transplantation, and comprehensive conservative management for patients with kidney failure in Europe. Kidney Int. 2021;100:182-95. doi:10.1016/J.KINT.2020.12.010

Kelly DM, Anders HJ, Bello AK, Choukroun G, Coppo R, Dreyer G, et al. International Society of Nephrology Global Kidney Health Atlas: structures, organization, and services for the management of kidney failure in Western Europe. Kidney Int Suppl. 2021;11:e106-18. doi:10.1016/j.kisu.2021.01.007

de Jong RW, Stel VS, Heaf JG, Murphy M, Massy ZA, Jager KJ. Non-medical barriers reported by nephrologists when providing renal replacement therapy or comprehensive conservative management to end-stage kidney disease patients: a systematic review. Nephrol Dial Transplant. 2021;36:848-62. doi:10.1093/NDT/GF2721

Okamoto I, Tonkin-Crine S, Rayner H, Murtagh FE, Farrington K, Caskey F, et al. Conservative care for ESRD in the United Kingdom: a national survey. Clin J Am Soc Nephrol. 2015;10:120-6. doi:10.2215/CJN.050005114

Ordem dos Médicos. Colégios: Nefrologia [Accessed May 22, 2026] Available at: https://ordemdosmedicos.pt/a-ordem/orgaos-tecnicos/colegios/especialidades/nefrologia/internato

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Published

22-06-2026

Issue

Section

Current Perspectives

How to Cite

The Evolution of Conservative Care in Portugal: From Ethical Foundations to Systematic Implementation. (2026). Portuguese Kidney Journal. https://doi.org/10.71749/pkj.151

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