Renal supportive care

Chronic kidney disease causes a slow loss of kidney function, including the ability to remove waste and maintain normal blood pressure, water and electrolyte balance. Chronic kidney disease has a high symptom burden and is associated with other chronic diseases (such as diabetes) and limited lifespan.

The NSW renal supportive care model is an integral part of renal services. It supports patients' quality of life and wellbeing while living with chronic kidney disease.

Renal supportive care involves an interdisciplinary approach, integrating renal medicine and palliative care services, and encompassing advance care planning and end-of-life care. Renal supportive care has the following features:

  • The renal team responsible for long-term treatment remains with the patient from chronic kidney disease diagnosis to the end of life
    • The nephrologist provides local leadership for the service
    • The model is primarily nurse-coordinated, supported by a dietitian, social worker and a physician or medical consultant (where available)
  • Care involves physical, psychological, emotional and spiritual dimensions and support for families and carers
  • Care is provided as close to home as possible, considering patient preferences
  • Patient-reported experience and outcome measures are collected and acted upon

In 2015/16, NSW Health provided recurrent funding for the statewide roll out of the Renal Supportive Care Model in a networked approach.


Snapshot of chronic kidney disease in NSW

In 2013...
About 21,000
people had stage 4 and
stage 5 chronic kidney
disease in NSW

  • During the early stages of the disease, patients often show no symptoms.
  • For stage 4 and 5 patients, kidney function is likely to deteriorate to a point where life-changing decisions need to be made.
  • These patients often have symptoms such as pain, severe skin irritation, digestive issues and/or distress.
  • Treatment options include: home, hospital or satellite dialysis, conservative care and transplantation.

Service model

NSW Renal Supportive Care

Care for patients with chronic or end stage kidney disease (mainly stage four and five), who are:

  • deciding on treatment pathway
  • being managed conservatively
  • receiving renal replacement therapies (dialysis or transplant)
  • withdrawing from dialysis.
View service model

For clinicians and services

What to improve

Read about the four clinical priority areas to manage chronic kidney disease:

  1. share decision-making
  2. refer to renal supportive care service
  3. minimise patient suffering
  4. ongoing supportive care

How to improve

Explore options for different organisational models to tailor clinical services for your local requirements:

  • coordinated multidisciplinary model
  • outreach model based on a renal supportive nurse

Additional resources

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