Dialysis in the elderly

Blood Purification
Madhukar Misra

Abstract

More and more elderly (>65 years) patients are now reaching end-stage renal disease (ESRD) due to better management of co-morbid diseases. There are complex medical issues that need to be addressed when managing ESRD in this patient group. The option of dialysis in the elderly is a viable one. However, it needs careful consideration of patients' choices besides coexisting illnesses. Ideally, dialysis should prolong survival. However, an equally important issue is quality of life on dialysis. Life should be added to years and not years added to life. This often involves multidisciplinary input from various disciplines involved in patient care. Other than life on dialysis, the only other alternative is conservative management. Conservative management is not 'passive palliative therapy'. Rather, it involves active management of various clinical issues in a sick and vulnerable patient who does not have age on his side. All elderly patients have unique issues and no generalizations can be made. However, careful analysis makes it possible to offer dialysis to the right patient in the elderly and very elderly (>75 years and beyond) subgroups.

References

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Citations

Apr 17, 2009·Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association·Luigi Francesco MorroneUNKNOWN CPCP Study Investigators
Jun 30, 2009·Seminars in Dialysis·Indranil Dasgupta, Hugh C Rayner
Dec 19, 2013·Nephro-urology Monthly·Zohreh Rostami
Aug 6, 2013·The Journals of Gerontology. Series A, Biological Sciences and Medical Sciences·Chun Keung ShumKa Foon Chau

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