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      Predialyis nephrology care of older individuals approaching end-stage renal disease.

      1 ,
      Seminars in dialysis
      Wiley

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          Abstract

          Many older patients with advanced CKD approaching ESRD do not receive timely nephrology care, although data suggest that the situation may be improving. In 2005-2008, 43% of older patients who initiated renal replacement therapy had experienced an outpatient nephrologist consultation more than 1 year before starting treatment. Earlier consultation with a nephrologist has been found to provide better access to peritoneal dialysis and kidney transplantation, better preparation for the chosen dialytic modality, and improved survival after start of dialysis or receipt of a kidney transplant. Recent data suggest that older individuals are less likely to receive treatment for ESRD compared with younger individuals in whom almost all receive dialysis treatment or transplantation. Little is known about the role nephrologists play in the decision whether to initiate dialysis or choose a conservative route among older adults with ESRD. Defining the appropriate role and involvement of nephrologists in the decision about initiating renal replacement therapy in older adults seems ripe for further investigation and discussion.

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          Author and article information

          Journal
          Semin Dial
          Seminars in dialysis
          Wiley
          1525-139X
          0894-0959
          November 24 2012
          : 25
          : 6
          Affiliations
          [1 ] Division of Nephrology, Stanford University School of Medicine, Palo Alto, California 94304, USA. wcw1@stanford.edu
          Article
          10.1111/sdi.12036
          23173891
          b1189ac3-353d-4b5f-a07d-06802bff555a
          History

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