Geriatric nephrology units: the way of the future

The emergence of the sub-speciality geriatric nephrology is an exciting development for the future. The main objectives should be to maximise patient independence and minimise deterioration and learn dependent behaviour in this population. To achieve these goals a holistic approach needs to be taken, to the patient, their environment and the efficacy of such units, and this can only be achieved using a multi-disciplinary team approach. In the creation of a geriatric nephrology unit it is important to identify the factors that cause frailty and, if possible, modify or prevent the initial decline using nutritional and other interventions. This requires careful monitoring, not only using the traditional markers of renal disease including urea and creatinine, but also using instruments that measure functional ability. These issues are discussed under the headings prevention, documentation and planning.