New research on care and support for children and their families receiving conservative care for kidney failure

04 March 2026

In a study published in Archives of Disease in Childhood, Dr Lucy Plumb and the team at the UK Renal Registry, funded by the Children’s Research Fund and supported by Kidney Research UK, aimed to identify children in the UK and Ireland who developed kidney failure and who received conservative care. Lucy and the team described factors that influence this treatment choice, and the clinical care and support provided to children and their families.

What is conservative care?

Conservative care involves kidney care and treatments that aim to keep you well for as long as possible by supporting your kidney function and managing your symptoms of kidney failure, without dialysis or transplant. You may also hear conservative care called supportive care, comprehensive conservative care or conservative kidney management.

Caring for children receiving conservative care and supporting their families

Understanding more about the children who receive conservative care and their families and the factors that influence this choice is important for ensuring that they receive the best clinical care and support. Currently, the UK Renal Registry routinely collects information on children and adults who receive kidney replacement therapies. Little is known, either in the UK or other countries, about those who receive conservative care.

“The UK Renal Registry collects information on adults and children receiving kidney replacement therapies, which is used, nationally and at local level, to audit their care and outcomes.

"Working at the registry, I recognised that there was an important gap in our knowledge: that we knew very little about children with kidney failure who received conservative kidney care and therefore did not know much about the care and support they received.

"This study aimed to address this, and to shine a light on all children with kidney failure. Our hope for the future is to try and routinely capture more information about these children; to help make sure they receive the best care possible”. Dr Lucy Plumb

Dr Lucy Plumb

Understanding the children most likely to receive conservative care

Over a two-year period, Lucy and the team sent questionnaires to doctors caring for children in the UK and Ireland. From this they received data on 27 children who developed kidney failure and for whom a decision had been made for conservative kidney care. Overall, children receiving conservative kidney care accounted for about 10% of all UK childhood kidney failure.

Children who received conservative care were young, with over a third less than 28 days old. The proportion of Black (8%) and Asian (40%) children who received conservative care was higher than those who had a transplant or started dialysis in the same timeframe, with further research needed to understand the reasons for this.

Many children receiving conservative care also had additional health concerns, with over half having developmental delay, congenital (diseases present from birth) and genetic (inherited) conditions. After a year, 18 of the 27 of children receiving conservative care had died, 5 remained on conservative care and 2 had started dialysis.

What could this mean for children and families?

Understanding which children with kidney failure may receive conservative care, the factors that influence this treatment choice, and the care and support provided could help make improvements in the future to ensure children and families receive the best clinical care and most useful support.

“Through this research we were able to capture important information about children receiving conservative kidney care and how their care is managed. Next, I’d like to take what we’ve identified and speak to families to understand what we can do to help support them and their children, something we can only begin to understand from their experiences.” Dr Lucy Plumb