Nutrition in elderly dialysis patients

The end-stage renal disease (ESRD) population is aging, and currently approximately 50% of patients treated with maintenance dialysis are more than 65 years old. With advancing age comes challenges to maintaining the nutritional status of these patients. As patients get older, purchasing and preparing food may become more difficult. In addition, appetite may decrease, the occurrence of intercurrent illnesses may become more frequent, and nutrient requirements change. Mobility may decline, as well as cognitive function, and the combination of several of these factors may result in malnutrition. Since malnutrition has been demonstrated to impact survival in dialysis patients of all ages, appropriate attention to nutritional status and its management is essential for the elderly dialysis patient. This article reviews the issues associated with the maintenance of good nutrition in the elderly dialysis patient and describes the potential causes of malnutrition in these patients. It also reviews the nutrient requirements for older dialysis patients (which differ somewhat from those of younger patients), as well as the assessment of their nutritional status. Finally, recommendations for management of nutrition in the elderly dialysis patient are discussed.