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Renal replacement therapy in the elderly.

Xiaoyi Ye¹, Anjay Rastogi, Allen R Nissenson

¹Division of Nephrology, Department of Medicine, David Geffen School of Medicine at UCLA, 10833 Le Conte Avenue, Room 7-155 Factor Building, Los Angeles, CA 90095, USA. xye@mednet.ucla.edu

Clinics in Geriatric Medicine

|September 22, 2009

Summary

As the US population ages, chronic kidney disease and end-stage renal disease impact the elderly. This article addresses challenges and ethical considerations for geriatric dialysis patients.

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Area of Science:

Nephrology
Geriatrics
Public Health

Background:

Rising rates of chronic kidney disease (CKD) and end-stage renal disease (ESRD) in the aging United States population.
Elderly patients with CKD or ESRD encounter unique medical care challenges.
The aging demographic presents medical, psychosocial, and ethical considerations for healthcare providers.

Purpose of the Study:

To discuss the specific issues faced by the geriatric dialysis population.
To highlight that advanced age should not preclude renal replacement therapy initiation.
To prepare physicians for the complexities of geriatric care in nephrology.

Main Methods:

Review of current literature on geriatric nephrology.
Analysis of challenges in managing elderly patients with kidney failure.
Discussion of ethical considerations in dialysis decisions for older adults.

Main Results:

Elderly individuals with kidney disease face distinct medical and psychosocial hurdles.
Renal replacement therapy is a viable option for many elderly patients.
Age-related changes necessitate tailored approaches to dialysis care.

Conclusions:

Geriatric dialysis requires specialized medical, ethical, and psychosocial management.
Physicians must adapt care strategies to meet the needs of an aging patient population.
Initiation of renal replacement therapy should be considered for elderly patients based on individual assessment, not solely on age.