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[One hundred years old and under haemodialysis treatment for 5 years...a case to ponder]
A Di Benedetto1, A Buono, F Cappabianca
1Fresenius Medical Care Italia, Napoli. attilio.dibenedetto@fmc-ag.com
Background:
The average age of the patients, introduced in the dialytic programme, is progressively increasing in relation to the prolonging of life and to the technological progresses. All this places the nephrologist to ask himself if the age has to be considered a limiting factor for the introduction of a patient in the dialytic programme.
Case Report:
We report on a patient who started her dialytic programme when she was 95. After 5 years, at the age of 100, she uneventfully completed 60 months of haemodialytic treatment. Right from the start we decided to use as vascular access a double Tesio catheter, which was never replaced because it was the most appropriate for the patient's age. During the follow-up period the patient was not hospitalised and her clinical condition was satisfactory.
Discussion:
According to the latest epidemiological and clinical data, this case emphasises the concept that it would be wrong to refuse the haemodialytic treatment to such patients only because of their frailty. Moreover, the lack of either univocal prognostic indications, based on scientific criteria, or special national laws confirm that the decision to treat the patient depends exclusively on the physician's ethical and professional background as well as the patient's autonomy and conscience.
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