Current and emerging treatment options for the elderly patient with chronic kidney disease

Fassett, Robert G. (2014) Current and emerging treatment options for the elderly patient with chronic kidney disease. Clinical Interventions in Aging, 9 191-199. doi:10.2147/CIA.S39763


Author Fassett, Robert G.
Title Current and emerging treatment options for the elderly patient with chronic kidney disease
Journal name Clinical Interventions in Aging   Check publisher's open access policy
ISSN 1176-9092
1178-1998
Publication date 2014-01-15
Year available 2014
Sub-type Critical review of research, literature review, critical commentary
DOI 10.2147/CIA.S39763
Open Access Status DOI
Volume 9
Start page 191
End page 199
Total pages 9
Place of publication Auckland, New Zealand
Publisher Dove Medical Press
Collection year 2015
Language eng
Abstract The objective of this article is to review the current and emerging treatments of CKD prior to dialysis in the elderly. Worldwide, there are increasing numbers of people who are aged over 65 years. In parallel, there are increasing numbers of elderly patients presenting with chronic kidney disease (CKD), particularly in the more advanced stages. The elderly have quite different health care needs related to their associated comorbidity, frailty, social isolation, poor functional status, and cognitive decline. Clinical trials assessing treatments for CKD have usually excluded patients older than 70-75 years; therefore, it is difficult to translate current therapies recommended for younger patients with CKD across to the elderly. Many elderly people with CKD progress to end-stage kidney disease and face the dilemma of whether to undertake dialysis or accept a conservative approach supported by palliative care. This places pressure on the patient, their family, and on health care resources. The clinical trajectory of elderly CKD patients has in the past been unclear, but recent evidence suggests that many patients over 75 years of age with multiple comorbidities have greatly reduced life expectancies and quality of life, even if they choose dialysis treatment. Offering a conservative pathway supported by palliative care is a reasonable option for some patients under these circumstances. The elderly person who chooses to have dialysis will frequently have different requirements than younger patients. Kidney transplantation can still result in improved life expectancy and quality of life in the elderly, in carefully selected people. There is a genuine need for the inclusion of the elderly in CKD clinical trials in the future so we can produce evidence-based therapies for this group. In addition, new therapies to treat and slow CKD progression are needed for all age groups.
Keyword Frailty
Functional status
Palliative care
Elderly
Dialysis
Kidney transplantation
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Critical review of research, literature review, critical commentary
Collections: Official 2015 Collection
School of Human Movement and Nutrition Sciences Publications
School of Medicine Publications
 
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