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Special considerations for the treatment of chronic kidney disease in the elderly

Andrea Corsonello1, Sergio Fusco1, Silvia Bustacchini2

  • 1a Italian National Research Center on Aging, Unit of Geriatric Pharmacoepidemiology , Research Hospital of Cosenza , Cosenza , Italy.

Expert Review of Clinical Pharmacology
|February 18, 2016
PubMed

Insights

Chronic kidney disease (CKD) management in older adults requires tailored approaches. Geriatric assessment and rehabilitation may improve decision-making and outcomes for elderly patients with CKD.

Area of Science:

  • Nephrology
  • Geriatrics
  • Internal Medicine

Background:

  • Chronic kidney disease (CKD) disproportionately affects older adults, with increasing prevalence expected.
  • Current CKD guidelines lack specific recommendations for elderly patients.
  • Pharmacological management and renal replacement therapy (RRT) decisions for older adults are not evidence-based.

Purpose of the Study:

  • To highlight the evolving knowledge and challenges in managing older adults with CKD.
  • To emphasize the need for tailored approaches in pharmacological management and RRT decisions.
  • To explore the utility of geriatric assessment and rehabilitation interventions in this population.

Main Methods:

  • Review of current literature and guidelines concerning CKD in older adults.
  • Analysis of decision-making processes for renal replacement therapy in the elderly.
  • Discussion of the potential role of comprehensive geriatric assessment tools.
  • Exploration of physical exercise and rehabilitation as therapeutic strategies.

Main Results:

  • Existing CKD guidelines do not adequately address the needs of older patients.
  • RRT may offer more harm than benefit in older adults if prognostic stratification is not carefully considered.
  • Comprehensive geriatric assessment tools can aid in informed clinical decision-making.
  • Physical exercise and rehabilitation show promise as therapeutic interventions.

Conclusions:

  • A specialized approach is needed for managing older adults with CKD.
  • Geriatric assessment tools are crucial for optimizing treatment decisions, including RRT.
  • Physical exercise and rehabilitation interventions represent a promising therapeutic avenue for elderly CKD patients.

Keywords:
Chronic kidney diseaseacidosisalbuminuriaanemiacomprehensive geriatric assessmentdiabeteshypertensionosteoporosisrehabilitationrenal replacement therapy

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