– A 2025 Cochrane review of 24 non-randomised studies (26,127 people aged ≥65 with stage 5 CKD) found very low‑certainty evidence when comparing conservative kidney management (CKM) to dialysis.
– Observational synthesis suggested higher all-cause mortality with CKM (RR 1.28; 95% CI 1.17–1.41) but evidence is very low certainty due to severe confounding and heterogeneity.
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