Referral of elderly patients with end-stage renal failure for renal replacement therapy

An increasing number of patients with end-stage renal failure is being treated in the United Kingdom and in 1987 approximately 50 new patients per million started renal replacement therapy. Nevertheless comparatively fewer patients are treated in this country than in some other European countries and in North America. During the 3 years 1985 to 1988, 95 patients from West Glamorgan started chronic renal replacement therapy (87 patients/million population/year). Of these, 16 were aged 75 years or over on starting treatment. In addition two others attained the age of 75 years during the study period. The proportion of elderly new patients is increasing and in the year 1987 to 1988, 59 per cent were older than 65 years and 32 per cent were older than 75 years. Throughout the United Kingdom many elderly patients are being denied treatment, due partly to under-referral.