Dialysis in the old: a centenarian nursing home resident with end-stage renal disease

Aging trends in the U.S. have resulted in the over 65 years age group with End Stage Renal Disease (ESRD) becoming the fastest growing segment of the population presenting for dialysis. Their profile differs from younger adults in that they present with significant comorbidity and vascular access problems, and require earlier preparation for dialysis. ESRD in the geriatric population most commonly results from diabetes, hypertension, glomerular and tubulointerstitial nephritis. Described are experiences with initiating a centenarian nursing home resident with uremia on hemodialysis; resulting in improved quality of life and illustrating that age alone should never be a barrier to receiving dialysis. Renal replacement therapy can enhance quality of life and function even in the old. A review of select literature pertinent to ESRD in the geriatric population follows.