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Treatment of chronic kidney disease in older populations
Seiji Kishi1, Hiroyuki Kadoya2, Naoki Kashihara3,4
1Department of Nephrology and Hypertension, Kawasaki Medical School, Kurashiki, Japan.
Insights
Managing chronic kidney disease (CKD) in aging populations requires integrated strategies. Emerging therapies and patient-centered approaches are key to improving outcomes and quality of life for older adults with CKD.
Area of Science:
- Nephrology
- Geriatrics
- Public Health
Background:
- Global population aging is increasing chronic kidney disease (CKD) prevalence in older adults.
- CKD management in the elderly presents significant healthcare resource challenges.
- Standard CKD treatment goals include reducing cardiovascular events and kidney failure progression.
Purpose of the Study:
- To outline effective management strategies for CKD in the aging population.
- To highlight the role of emerging pharmacotherapies and non-pharmacological interventions.
- To emphasize patient-centered decision-making for kidney replacement therapy.
Main Methods:
- Review of current treatment guidelines and emerging therapies for CKD in older adults.
- Discussion of non-pharmacological interventions like nutrition and exercise.
- Exploration of factors influencing kidney replacement therapy decisions.
- Consideration of digital health integration in CKD management.
Main Results:
- SGLT-2 inhibitors and GLP-1 receptor agonists show promise for CKD management in the elderly.
- Nutritional and exercise therapies complement pharmacotherapy, improving quality of life and cognitive function.
- Individualized, patient-centered approaches are crucial for kidney replacement therapy decisions.
- Digital technologies offer potential for transforming CKD care in aging populations.
Conclusions:
- Integrated management strategies combining pharmacotherapy, non-pharmacological interventions, and patient-centered care are essential for older adults with CKD.
- Emerging therapies and digital health integration hold significant potential for improving CKD outcomes in the aging demographic.
- Tailored treatment plans, considering individual factors beyond age and cognition, are paramount for kidney failure management.
Abstract:
As the world population ages, an expected increase in the prevalence of chronic kidney disease (CKD) among older individuals will pose a considerable challenge for health care systems in terms of resource allocation for disease management. Treatment strategies for older patients with CKD should ideally align with those applied to the general population, focusing on minimizing cardiovascular events and reducing the risk of progression to kidney failure. Emerging therapies, such as SGLT-2 inhibitors and GLP-1 receptor agonists, hold promise for the effective management of CKD in older individuals. In addition, non-pharmacological interventions such as nutritional and exercise therapies have a crucial role. These interventions enhance the effects of pharmacotherapy and, importantly, contribute to the maintenance of cognitive function and overall quality of life. Various factors beyond age and cognitive function must be taken into account when considering kidney replacement therapy for patients with kidney failure. Importantly, all treatment options, including dialysis, transplantation and conservative management approaches, should be tailored to the individual through patient-centred decision-making. The dynamic integration of digital technologies into medical practice has the potential to transform the management of CKD in the aging population.
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