title: The dialytic management of acute renal failure in the elderly.
abstract: In this article the different dialysis strategies in the management of acute renal failure (ARF) in the elderly are discussed. Although peritoneal dialysis (PD) offers some theoretical advantages, there are several medical and technical reasons why it is currently less frequently used. The choice between intermittent hemodialysis (HD) and continuous renal replacement therapy (CRRT) is determined by a number of considerations, the most important ones being hemodynamic stability, the need for hyperalimentation and/or ultrafiltration, and the local experience with one or both techniques. Some recent studies with CRRT in elderly ARF patients describe favorable results. Slow extended daily dialysis (SLEDD) modalities may be particularly indicated in elderly, critically ill ARF patients because these techniques combine the advantages of both CRRT and HD. Finally, the importance of the biocompatibility of dialysis membranes is discussed. Although there are a number of theoretical arguments to use biocompatible membranes, this opinion is not always supported by the results of recent comparative studies. It is the opinion of the authors that all dialysis strategies should be mastered and utilized for appropriate indications in elderly ARF patients.
authors.affiliation: Division of Geriatric Medicine, Department of Medicine, University Hospital, Ghent, Belgium. ingrid.verslycken@rug.ac.be
authors.forename: Nele
authors.initials: N
authors.lastname: Van de Noortgate
authors.forename: Francis
authors.initials: F
authors.lastname: Verbeke
authors.forename: Annemieke
authors.initials: A
authors.lastname: Dhondt
authors.forename: Francis
authors.initials: F
authors.lastname: Colardijn
authors.forename: Wim
authors.initials: W
authors.lastname: Van Biesen
authors.forename: Raymond
authors.initials: R
authors.lastname: Vanholder
authors.forename: Norbert
authors.initials: N
authors.lastname: Lameire
mesh_terms: D058186:Acute Kidney Injury / Q000628:therapy*; D000368:Aged; D001672:Biocompatible Materials; D006801:Humans; D008567:Membranes, Artificial; D010530:Peritoneal Dialysis; D006435:Renal Dialysis / Q000379:methods
chemical_list: D001672:Biocompatible Materials; D008567:Membranes, Artificial