Abstract
<jats:title>Abstract</jats:title> <jats:p>Kidney supportive care (KSC) represents a vital alliance between nephrology and palliative care, addressing the holistic needs of patients with advanced kidney disease, whether receiving kidney replacement therapy managed conservatively. This chapter emphasises that not all patients benefit from dialysis, particularly older, highly comorbid individuals, and highlights the importance of symptom management, advance care planning, and end-of-life care. Key symptoms such as fatigue, pain, pruritus, and restless legs syndrome are explored, alongside psychological impacts and caregiver burden. The integration of KSC aims to improve quality of life through meticulous symptom control, compassionate communication, and structured support, ensuring care aligns with patient values and goals throughout their illness trajectory.</jats:p>