Participants can choose to withdraw from the study at any time and return to making all treatment decisions as they did before.

For people randomised to prepare for responsive management

• If someone no longer wants to prepare for responsive management, they can come out of the trial and make plans with their kidney team to prepare for renal dialysis. They will receive care that is identical to that which they would have received had they been randomised to prepare for renal dialysis in the first place.

For people randomised to prepare for renal dialysis

• If someone no longer wants to prepare for renal dialysis, they can come out of the trial and make plans with their kidney team to have non-dialysis treatment. It will not be possible for them to switch to responsive management, as this pathway was developed specifically for the study and is not standardised in the NHS. These people will receive the non-dialysis care routinely offered by their local kidney unit.