Comprehensive conservative care: what doctors say, what patients hear.

This article focuses on comprehensive conservative care (CCC) as an alternative, holistic, patient-centered treatment for advanced chronic kidney disease (CKD) stage 5 patients who opt not to undergo dialysis. Despite CCC's recognized benefits—particularly for elderly, frail, or comorbid patients—its practical implementation remains limited due to significant communication gaps between nephrologists and patients, inconsistent terminology, cultural factors, and resource constraints. The review highlights that while CCC is widely available at institutional levels, fewer than half of eligible patients are informed about it, and even fewer understand or document it as a treatment option. To improve CCC uptake, the article proposes earlier, clearer, and culturally sensitive communication strategies, enhanced shared decision-making processes, dedicated training for healthcare providers, and coordinated care pathways emphasizing quality of life and advance care planning.