Renal Supportive Care is a ‘non-dialysis’ conservative pathway for the management of end stage kidney disease (ESKD) patients who are elderly, or may have significant comorbidities, poor functional status, malnutrition or those who reside in a nursing homes. It is a culturally appropriate, team orientated and client focused pathway offering holistic care to patients and their families in their comfortable dwellings. Studies have shown that many of these patients live much longer without dialysis than might have been expected with a substantial quality of life compare to those who commence dialysis. Despite having witnessed many positive outcomes in our patients on this pathway, we also face some challenges in our renal supportive care journey. These ranges from the availability of resources, decision-making process, cultural appropriateness, staffing, language barriers and many more. This presentation will outline our Renal Supportive Care journey in TERS, how we do our things slightly different from the others, our strengths and our challenges.