Epidemiology and Management of End-stage Renal Disease in the Elderly

Overview

Journal Nat Rev Nephrol

Specialty Nephrology

Date 2011 Sep 1

PMID 21878885

Citations 25

Authors

Edwina A Brown

Lina Johansson

Affiliations

Soon will be listed here.

Abstract

Elderly patients with end-stage renal disease (ESRD) are at increased risk of developing aging-related problems, such as frailty, impaired physical function, falls, poor nutrition and cognitive impairment. These factors affect dialysis outcomes, which can be very poor in frail, elderly patients who often experience a decline in overall health and physical function and have short survival. The default treatment option for these patients is hospital-based hemodialysis, often with little consideration of how this modality will affect the survival or quality of life of individual patients. A comparison of quality of life of elderly patients on hemodialysis versus peritoneal dialysis shows that those on peritoneal dialysis have less illness intrusion. Assisted peritoneal dialysis enables a greater number of frail, elderly patients to have dialysis in their own homes. Dialysis may not extend survival for those with multiple comorbidities, so conservative care (nondialysis treatment) should be considered. To improve the outcomes of elderly patients with ESRD, it is necessary to develop a realistic approach to overall prognosis, quality of life and how the patient copes with the disabilities associated with aging. This approach includes having discussions regarding choice of treatment and end-of-life goals with patients and families.

Citing Articles

The relationship between body mass index changes and mortality in geriatric peritoneal dialysis patients: a case-control study.

Bildaci Y, Korucu B, Oktan M, Cavdar C, Deger S BMC Nephrol. 2024; 25(1):474.

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Survival rates in comprehensive conservative care compared to dialysis therapy in elderly end-stage kidney disease patients: a propensity score analysis.

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Peritoneal dialysis-related infections in elderly patients.

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Capacity for the management of kidney failure in the International Society of Nephrology Oceania and South East Asia (OSEA) region: report from the 2023 ISN Global Kidney Health Atlas (ISN-GKHA).

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Mortality of Peritoneal Dialysis versus Hemodialysis in Older Adults: An Updated Systematic Review and Meta-Analysis.

Cheng L, Hu N, Song D, Chen Y Gerontology. 2024; 70(5):461-478.

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