Current and emerging treatment options for the elderly patient with chronic kidney disease

Robert G Fassett The University of Queensland School of Human Movement Studies, Brisbane, Queensland, Australia Abstract: The objective of this article is to review the current and emerging treatments of CKD prior to dialysis in the elderly. Worldwide, there are increasing numbers of people who are...

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Autor principal:	Fassett RG
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2014
Materias:	Frailty functional status palliative care chronic kidney disease elderly dialysis kidney transplantation Geriatrics RC952-954.6
Acceso en línea:	https://doaj.org/article/3af63d9634ec455f8f13dd207fe7f43b
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spelling	oai:doaj.org-article:3af63d9634ec455f8f13dd207fe7f43b2021-12-02T00:44:50ZCurrent and emerging treatment options for the elderly patient with chronic kidney disease1178-1998https://doaj.org/article/3af63d9634ec455f8f13dd207fe7f43b2014-01-01T00:00:00Zhttps://www.dovepress.com/current-and-emerging-treatment-options-for-the-elderly-patient-with-ch-peer-reviewed-article-CIAhttps://doaj.org/toc/1178-1998Robert G Fassett The University of Queensland School of Human Movement Studies, Brisbane, Queensland, Australia Abstract: The objective of this article is to review the current and emerging treatments of CKD prior to dialysis in the elderly. Worldwide, there are increasing numbers of people who are aged over 65 years. In parallel, there are increasing numbers of elderly patients presenting with chronic kidney disease (CKD), particularly in the more advanced stages. The elderly have quite different health care needs related to their associated comorbidity, frailty, social isolation, poor functional status, and cognitive decline. Clinical trials assessing treatments for CKD have usually excluded patients older than 70–75 years; therefore, it is difficult to translate current therapies recommended for younger patients with CKD across to the elderly. Many elderly people with CKD progress to end-stage kidney disease and face the dilemma of whether to undertake dialysis or accept a conservative approach supported by palliative care. This places pressure on the patient, their family, and on health care resources. The clinical trajectory of elderly CKD patients has in the past been unclear, but recent evidence suggests that many patients over 75 years of age with multiple comorbidities have greatly reduced life expectancies and quality of life, even if they choose dialysis treatment. Offering a conservative pathway supported by palliative care is a reasonable option for some patients under these circumstances. The elderly person who chooses to have dialysis will frequently have different requirements than younger patients. Kidney transplantation can still result in improved life expectancy and quality of life in the elderly, in carefully selected people. There is a genuine need for the inclusion of the elderly in CKD clinical trials in the future so we can produce evidence-based therapies for this group. In addition, new therapies to treat and slow CKD progression are needed for all age groups. Keywords: frailty, functional status, palliative care, elderly, dialysis, kidney transplantationFassett RGDove Medical PressarticleFrailtyfunctional statuspalliative carechronic kidney diseaseelderlydialysiskidney transplantationGeriatricsRC952-954.6ENClinical Interventions in Aging, Vol Volume 9, Pp 191-199 (2014)
institution	DOAJ
collection	DOAJ
language	EN
topic	Frailty functional status palliative care chronic kidney disease elderly dialysis kidney transplantation Geriatrics RC952-954.6
spellingShingle	Frailty functional status palliative care chronic kidney disease elderly dialysis kidney transplantation Geriatrics RC952-954.6 Fassett RG Current and emerging treatment options for the elderly patient with chronic kidney disease
description	Robert G Fassett The University of Queensland School of Human Movement Studies, Brisbane, Queensland, Australia Abstract: The objective of this article is to review the current and emerging treatments of CKD prior to dialysis in the elderly. Worldwide, there are increasing numbers of people who are aged over 65 years. In parallel, there are increasing numbers of elderly patients presenting with chronic kidney disease (CKD), particularly in the more advanced stages. The elderly have quite different health care needs related to their associated comorbidity, frailty, social isolation, poor functional status, and cognitive decline. Clinical trials assessing treatments for CKD have usually excluded patients older than 70–75 years; therefore, it is difficult to translate current therapies recommended for younger patients with CKD across to the elderly. Many elderly people with CKD progress to end-stage kidney disease and face the dilemma of whether to undertake dialysis or accept a conservative approach supported by palliative care. This places pressure on the patient, their family, and on health care resources. The clinical trajectory of elderly CKD patients has in the past been unclear, but recent evidence suggests that many patients over 75 years of age with multiple comorbidities have greatly reduced life expectancies and quality of life, even if they choose dialysis treatment. Offering a conservative pathway supported by palliative care is a reasonable option for some patients under these circumstances. The elderly person who chooses to have dialysis will frequently have different requirements than younger patients. Kidney transplantation can still result in improved life expectancy and quality of life in the elderly, in carefully selected people. There is a genuine need for the inclusion of the elderly in CKD clinical trials in the future so we can produce evidence-based therapies for this group. In addition, new therapies to treat and slow CKD progression are needed for all age groups. Keywords: frailty, functional status, palliative care, elderly, dialysis, kidney transplantation
format	article
author	Fassett RG
author_facet	Fassett RG
author_sort	Fassett RG
title	Current and emerging treatment options for the elderly patient with chronic kidney disease
title_short	Current and emerging treatment options for the elderly patient with chronic kidney disease
title_full	Current and emerging treatment options for the elderly patient with chronic kidney disease
title_fullStr	Current and emerging treatment options for the elderly patient with chronic kidney disease
title_full_unstemmed	Current and emerging treatment options for the elderly patient with chronic kidney disease
title_sort	current and emerging treatment options for the elderly patient with chronic kidney disease
publisher	Dove Medical Press
publishDate	2014
url	https://doaj.org/article/3af63d9634ec455f8f13dd207fe7f43b
work_keys_str_mv	AT fassettrg currentandemergingtreatmentoptionsfortheelderlypatientwithchronickidneydisease
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Current and emerging treatment options for the elderly patient with chronic kidney disease

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