Dialysis decisions and the elderly

It is ironic that the patients who were specifically excluded from dialysis at its inception, the elderly, are now the fastest growing segment of the dialysis population. Just because it is possible to dialyze elderly patients does not mean that it should be done. This article reviews the following topics as they relate to decisions about dialysis treatment in elderly people--medical outcomes, age as a selection criterion, allocation of scarce resources, and withholding and withdrawing dialysis--and presents an approach to reaching decisions about treatment of renal failure in the elderly.