Renal replacement therapy in geriatric end-stage renal disease patients: a clinical approach.

Abstract:

:The number of geriatric patients on dialysis is increasing. This is due to demographic factors, a wider acceptance of elderly patients on dialysis, and an earlier start of dialysis in this patient group. Recent studies have questioned the effect of dialysis on quality of life in elderly patients with severe comorbidity and showed limited survival in this specific patient group. Therefore, the decision whether or not to start dialysis may be a difficult one for both the clinician and patient. Risk scores can be of help in facilitating shared decision making, but not as a tool to withhold dialysis. However, in the elderly patient with severe comorbidity, conservative care can sometimes be a reasonable alternative to dialysis. In the process of shared decision making, a balance should be pursued between life expectancy and quality of life. If the decision to initiate dialysis is taken, choices have to be made regarding dialysis modality and treatment prescription. If adequate support is provided, assisted peritoneal dialysis can be an acceptable alternative to hemodialysis. Care for the elderly with end-stage renal disease should be undertaken by a multidisciplinary team with special dedication to a multidimensional approach in this population.

journal_name

Blood Purif

journal_title

Blood purification

authors

Kooman JP,Cornelis T,van der Sande FM,Leunissen KM

doi

10.1159/000334153

subject

Has Abstract

pub_date

2012-01-01 00:00:00

pages

171-6

issue

1-3

eissn

0253-5068

issn

1421-9735

pii

000334153

journal_volume

33

pub_type

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