Special considerations for the treatment of chronic kidney disease in the elderly

Expert Rev Clin Pharmacol. 2016;9(5):727-37. doi: 10.1586/17512433.2016.1155448. Epub 2016 Mar 4.

Abstract

Chronic kidney disease (CKD) is common in older adults, and its burden is expected to increase in older populations. Even if the knowledge on the approach to older patient with CKD is still evolving, current guidelines for pharmacological management of CKD does not include specific recommendations for older patients. Additionally, decision-making on renal replacement therapy (RRT) for older patients is far from being evidence-based, and despite the improvement in dialysis outcomes, RRT may cause more harm than benefit compared with conservative care when prognostic stratification is not carefully assessed. The use of comprehensive geriatric assessment tools could help clinicians in applying a more informed decision-making. Finally, physical exercise and rehabilitation interventions also represents a promising therapeutic strategy.

Keywords: Chronic kidney disease; acidosis; albuminuria; anemia; comprehensive geriatric assessment; diabetes; hypertension; osteoporosis; rehabilitation; renal replacement therapy.

Publication types

  • Review

MeSH terms

  • Aged
  • Humans
  • Renal Insufficiency, Chronic / therapy*
  • Renal Replacement Therapy / methods*