Via practica 6/2017

Deciding on dialysis patients in senior age

The problematics of elderly patients with an advanced renal disease and possibilities of its treatment are closely connected with the palliative care. Two possibilities of dealing with the health effects are dialysis and the conservative approach. Despite the fact, that the conservative treatment is in the defined subgroup of elderly patients an eligible alternative to dialysis, it is not considered by nephrologists much. Also, an approach of the so-called Shared Decision Making is not applied – this approach takes into account several aspects such as comprehensive assessment of a functional status of a senior, estimated prognosis and trajectory of a disease, preferences of a patient, their family and social background. The conservative treatment is comprehensive, based on principles of a palliative approach and all the patients with kidney failure at the end of their lives benefit from it regardless of the selected therapy.

Keywords: end-stage renal disease, elderly, dialysis, conservative management, shared decision making