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Recent insights into life expectancy with and without dialysis
Jane O Schell1, Maria Da Silva-Gane, Michael J Germain
1Section of Palliative Care and Medical Ethics, University of Pittsburgh School of Medicine, UPMC, Pittsburgh, Pennsylvania, USA. schelljo@upmc.edu
Current Opinion in Nephrology and Hypertension
|January 24, 2013
Summary
Prognostication tools help elderly dialysis patients and nephrologists make informed decisions. Understanding illness trajectory with or without dialysis improves shared decision-making for better quality of life.
Area of Science:
- Geriatric Nephrology
- Clinical Decision-Making
- Prognostic Modeling
Background:
- Elderly patients initiating dialysis face poor outcomes, including higher mortality and reduced quality of life.
- Nephrologists require effective strategies for dialysis decision-making discussions in this demographic.
- Prognostication tools are crucial for patients where dialysis burdens may exceed survival benefits.
Purpose of the Study:
- To review the latest research on elderly patient survival with and without dialysis.
- To identify prognostic factors for renal progression and survival in older adults.
- To explore integrative prognostic models for predicting patient outcomes.
Main Methods:
- Literature review of recent research on elderly dialysis patients.
- Analysis of prognostic factors influencing renal disease progression and survival.
- Definition and application of kidney illness disease trajectory concepts.
Main Results:
- Identified key prognostic factors for renal progression and survival in elderly individuals.
- Developed an understanding of the kidney illness disease trajectory, encompassing survival, quality of life, and symptoms.
- Highlighted the utility of prognostic information for predicting short-term and long-term outcomes.
Conclusions:
- Shared decision-making requires integrating medical data with patient preferences for elderly patients with advanced kidney disease.
- Prognostic information and observational data empower nephrologists to predict illness trajectories.
- Facilitates informed conversations about dialysis treatment options for older adults.
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