title: Age and treatment of kidney failure.
abstract: OBJECTIVE
  This review discusses issues related to treatment of chronic kidney disease, and kidney failure in particular, among older adults.
  
  
  RESULTS
  A substantial proportion of older adults have chronic kidney disease and progress to kidney failure. There is considerable variability in treatment practices for advanced kidney disease among older adults, and evidence that treatment decisions such as dialysis initiation may be made without adequate preparation. When initiated, survival among older adults on chronic dialysis remains poor, and is associated with a significant decline in functional status. There is also evidence to suggest that dialysis initiation may not reflect overall treatment goals of elderly patients, but rather a lack of clear communication between patients and health practitioners, and underdeveloped conservative care programs in many centers.
  
  
  CONCLUSIONS
  Kidney failure is common among older adults. When considering treatment options for kidney failure, patient priorities, preferences, and symptoms should be taken into account, using a shared decision-making approach.
authors: aDepartment of Medicine bDepartment of Community Health Sciences, University of Calgary, Calgary, Alberta, Canada.
authors: Meghan J
authors: MJ
authors: Elliott
authors: Helen
authors: H
authors: Tam-Tham
authors: Brenda R
authors: BR
authors: Hemmelgarn
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D003657:Decision Making; D003661:Decision Support Techniques; D018450:Disease Progression; D005919:Glomerular Filtration Rate; D006292:Health Priorities; D006801:Humans; D007668:Kidney / Q000503:physiopathology; D007676:Kidney Failure, Chronic / Q000453:epidemiology / Q000628:therapy; D057240:Patient Preference; D018579:Patient Selection; D015995:Prevalence; D051437:Renal Insufficiency / Q000175:diagnosis / Q000453:epidemiology / Q000401:mortality / Q000503:physiopathology / Q000628:therapy*; D017582:Renal Replacement Therapy / Q000009:adverse effects / Q000401:mortality; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome