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Decision-Making in Geriatric Patients with End-Stage Renal Disease: Thinking Beyond Nephrology

OSF Saint Anthony Medical Center, 5666 E State St, Rockford, IL 61108, USA
Baylor College of Medicine, One Baylor Plaza, Houston, TX 77030, USA
Michael E. DeBakey VA Medical Center, 2002 Holcombe Blvd, Houston, TX 77030, USA
Author to whom correspondence should be addressed.
J. Clin. Med. 2019, 8(1), 5;
Received: 21 November 2018 / Revised: 8 December 2018 / Accepted: 15 December 2018 / Published: 20 December 2018
(This article belongs to the Section Nephrology & Urology)
PDF [196 KB, uploaded 20 December 2018]


Compared to younger individuals, the prevalence of end-stage renal disease (ESRD) in elders is notably higher. While renal replacement therapy, usually with hemodialysis, is accepted therapy in younger patients with ESRD, decisions regarding the treatment of advanced kidney disease in the elderly population are more complex, secondary to the physiologic changes of aging, concurrent geriatric syndromes, and varying goals of care. Evaluation for possible initiation of dialysis in geriatric patients should be multidisciplinary in nature and patient-focused, including a consideration of physical, cognitive, and social function. If renal replacement therapy is not pursued, optimization of medical management or symptom management needs to be the goal of care. View Full-Text
Keywords: dialysis; palliative; older adults; transplantation dialysis; palliative; older adults; transplantation
This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited (CC BY 4.0).

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Ahmed, F.A.; Catic, A.G. Decision-Making in Geriatric Patients with End-Stage Renal Disease: Thinking Beyond Nephrology. J. Clin. Med. 2019, 8, 5.

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