Geriatric renal palliative care is coming of age

Excerpt

In 2003, Oreopoulos and Dimkovic called attention to the growing geriatric renal population, the need for a re-assessment of their management and aptly stated that “Geriatric nephrology is coming of age” [1]. Since that prescient observation, the dialysis experience in the elderly population has produced some somber facts. Understanding how to best treat these patients has assumed primary importance since dialysis units will soon be overpopulated by those older than 75 years, and the great majority will not receive transplants. The course for an individual patient remains uncertain even with the best prognostic tools. The future predicts an increasing elderly renal population whose main desire is to maintain independence and quality of life (QOL) through optimal mental capacity and physical functioning despite mounting comorbidities, geriatric syndromes and a shrinking personal world. How can we best prepare to meet this challenge? Is there an approach that engenders hope? A shift in perspective provides a starting point. …