Abstract
The number of patients developing kidney failure is increasing globally including in India. Dialysis is not the most optimal treatment for a number of these patients such as the elderly, the frail and those with multiple comorbidities and limited life expectancy. Moreover, some patients may prefer not to undergo dialysis. Supportive care focused on symptom management and improving the quality of life is a legitimate treatment option in these situations. It can be delivered alongside dialysis or to patients who choose to receive only conservative care and is being increasingly recognised as an integral component of holistic kidney care. Kidney care provider ecosystem needs to become aware of the principles of the principles of shared decision making, advanced care planning, understanding how to provide emotional, spiritual and information support to the patient and their families and when needed bereavement care. Supportive care facilities are underdeveloped in most low resource settings including in India. There is a need to develop capacity in this area so that our patients can derive the benefit of the full range of treatment options for kidney disease.