[Dialysis therapy for end stage renal disease in octogenarians]

End stage renal disease (ESRD) patients aged 80+ years raise the most difficult problems with respect to indication and dialysis therapy management because of the burden of heavy comorbidity, frequent cognitive disorders/and presumed short life expectancy. Some patients are withheld dialysis and follow a "conservative" treatment. However, most elderly patients are started on a chronic dialysis program and experience a substantial prolongation of life, with a satisfactory mental perception of the quality of life. Still, much remains to be done in this field: early nephrologic referral and psychosocial support should improve both the process of decision-making and the overall results of renal replacement therapy in this age group.