An integrative approach to advanced kidney disease in the elderly

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Jane O Schell1, Michael J Germain, Fred O Finkelstein

  • 1Department of Medicine, Duke University Medical Center, Durham, NC 27705-3860, USA. jane.schell@duke.edu <jane.schell@duke.edu>

Advances in Chronic Kidney Disease
|July 9, 2010
PubMed

Insights

Chronic kidney disease (CKD) is increasingly affecting older adults, with those over 75 being the fastest growing group starting dialysis. Management requires an integrated approach focusing on quality of life and end-of-life care.

Area of Science:

  • Nephrology
  • Geriatric Medicine
  • Palliative Care

Background:

  • Chronic kidney disease (CKD) is increasingly prevalent in the aging population, becoming a significant geriatric health concern.
  • Patients over 75 years old represent the fastest-growing demographic initiating dialysis.
  • Elderly dialysis patients often present with multiple comorbidities and functional limitations, impacting outcomes.

Purpose of the Study:

  • To review the unique challenges associated with dialysis initiation in elderly patients.
  • To outline essential considerations for managing this specific subpopulation.
  • To emphasize the need for a comprehensive, integrative care model.

Main Methods:

  • This review synthesizes current literature on CKD management in the elderly.
  • It focuses on challenges in dialysis initiation and ongoing care.
  • It highlights the importance of multidisciplinary collaboration.

Main Results:

  • Dialysis initiation in older adults presents distinct challenges due to comorbidities and functional decline.
  • Effective management requires addressing not only medical needs but also quality of life and psychosocial factors.
  • Timely discussions regarding goals of care and end-of-life preferences are crucial.

Conclusions:

  • An integrative approach combining nephrology, geriatric, and palliative medicine is essential for optimal care of elderly CKD patients.
  • This comprehensive strategy should address medical management, quality of life, and advance care planning.
  • Improved patient outcomes and quality of life can be achieved through tailored, holistic care models.

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