title: Dialysis options for end-stage renal disease in older people.
abstract: The numbers of older patients requiring dialysis therapy is rising, reflecting the ageing of the general population. Older dialysis patients have a tendency to present later for dialysis, have a higher number of comorbid conditions, are at higher risk of cognitive dysfunction and have increased levels of frailty. These are all barriers to home dialysis therapy so hospital haemodialysis (HD) is the predominant dialysis modality for older patients. Evidence suggests, however, that home treatment with peritoneal dialysis (PD) intrudes less into the life of older patients than hospital HD. Assisted PD is available in some countries and this enables more older patients to be treated in their own homes. Adjustments to patient education also need to be made to accommodate the barriers to learning and decision-making that often exist in older people.
authors.affiliation: Imperial College Kidney and Transplant Centre, Hammersmith Hospital, London, UK. e.a.brown @ imperial.ac.uk
authors.forename: Edwina A
authors.initials: EA
authors.lastname: Brown
authors.forename: Lina
authors.initials: L
authors.lastname: Johansson
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D016330:Frail Elderly; D014943:Global Health; D006297:Health Services Accessibility; D006436:Hemodialysis Units, Hospital / Q000706:statistics & numerical data; D006437:Hemodialysis, Home / Q000379:methods / Q000706:statistics & numerical data; D006801:Humans; D007676:Kidney Failure, Chronic / Q000453:epidemiology / Q000628:therapy*; D010353:Patient Education as Topic; D010530:Peritoneal Dialysis / Q000379:methods / Q000706:statistics & numerical data; D011157:Population Dynamics; D011788:Quality of Life; D012042:Registries; D006435:Renal Dialysis / Q000379:methods* / Q000706:statistics & numerical data; D016019:Survival Analysis