Letter to Primary Care Provider Regarding CKM Decision

[Nephrologist Name]
[CKD Clinic Name]
[Mailing Address Line 1]
[Mailing Address Line 2]
[Mailing Address Line 3]
[Clinic Phone Number]


[Name of Primary Care Provider]
[Mailing Address Line 1]
[Mailing Address Line 2]
[Mailing Address Line 3]

Dear Dr.  ,

Subject: The Choice of Conservative Kidney Management

Our mutual patient   (PHN  ) has advanced chronic kidney disease and is being followed by the Chronic Kidney Disease (CKD) Clinic for this condition. The patient has been fully informed of his or her treatment options, and it has been agreed upon by the patient, family, and kidney healthcare team that   will pursue a conservative kidney management strategy. This means that the patient has chosen not to have dialysis of any kind. This decision for conservative kidney management was based on the patient’s values, preferences, overall health, general function, and individual situation.

The progression of kidney disease is highly variable and it may be that the patient’s kidney function remains stable for some time. For as long as the patient is interested in attending the CKD Clinic, we will continue to manage  ’s kidney disease in the clinic with a focus on quality of life. This includes interventions aimed at preserving the patient’s remaining kidney function, avoiding complications related to end stage kidney disease, and managing the patient’s symptoms. We will also continue to review the patient’s wishes and we will regularly communicate our assessment findings with you.

As the patient’s kidney function declines to very low levels and symptoms of uremia develop, end of life care will need to be coordinated and the patient may no longer wish to or be able to attend the CKD Clinic. At that time or at any other time, it may be determined jointly between you, the patient, and the kidney healthcare team that the patient’s kidney disease needs may be best met by you, their primary care provider, in conjunction with support from the community (such as homecare or palliative care). We would not wish to interfere with your management of the patient but would hope to work collaboratively to support the patient’s needs and wishes.

To that end, we have developed an interactive online Conservative Kidney Management Clinical Pathway that can be accessed by any care provider. It includes symptom management guidelines, suggestions for chronic kidney disease and crisis management, information on referrals and community resources, and education materials for patients.


For matters that are beyond what the pathway can address, please do not hesitate to contact us by phone at  .



Copies to:
[Home Care Case Manager]

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