What can We Do to Improve Quality of Life for the Elderly Chronic Kidney Disease Patient?

Chronic kidney disease, including end stage, is more common with increasing age. It most commonly occurs alongside other diseases. There are therefore increasing numbers of older people living with chronic kidney disease alongside their other chronic conditions and the general problems associated with aging. Therefore, the quality of life needs to be a key outcome when considering management and interventions. Guidelines for referral to renal clinics should be followed in order to avoid unnecessary outpatient visits and investigations. Discussions with patients and families about dialysis should include impact on lifestyle and honesty about likely prognosis. For frail patients, there may be no difference in survival rates between those receiving conservative care and those on dialysis. Development of assisted peritoneal dialysis provides the option of home treatment rather than default hospital hemodialysis. Measures of quality and standard of treatment for older people with chronic kidney disease should move away from purely medical targets and include measures of patient outcomes.