Managing end-stage renal disease in the elderly: State-of-the-art, challenges and opportunities

Aging Health

Volumn 9, Issue 5, 2013, Pages 539-552

  Somma, Chiara ^a,b   Trillini, Matias ^a   Kasa, Marsida ^a,c   Gentile, Giorgio ^a,b  

^a MARIO NEGRI INSTITUTE FOR PHARMACOLOGICAL RESEARCH   (Italy)

^b PAPA GIOVANNI XXIII HOSPITAL   (Italy)

^c UNIVERSITY HOSPITAL CENTER MOTHER TERESA   (Albania)

Author keywords

aged; bioethical issues; comorbidity; delivery of healthcare; frail elderly; renal dialysis; renal insufficiency

Indexed keywords

AMLODIPINE; ANGIOTENSIN RECEPTOR ANTAGONIST; ANTIBIOTIC AGENT; ANTIHYPERTENSIVE AGENT; BETA ADRENERGIC RECEPTOR BLOCKING AGENT; CALCIUM CHANNEL BLOCKING AGENT; CHLORTALIDONE; CONTRAST MEDIUM; DIPEPTIDYL CARBOXYPEPTIDASE INHIBITOR; DIURETIC AGENT; LISINOPRIL; NONSTEROID ANTIINFLAMMATORY AGENT; THIAZIDE DIURETIC AGENT;

ACUTE KIDNEY FAILURE; AGING; BLOOD PRESSURE; CHRONIC KIDNEY DISEASE; COGNITIVE DEFECT; CONSERVATIVE TREATMENT; DEPRESSION; FALLING; FRAIL ELDERLY; GLOMERULUS FILTRATION; GLOMERULUS FILTRATION RATE; HEMODIALYSIS; HUMAN; HYPERTENSION; IMMUNE SYSTEM; INFLAMMATION; KIDNEY FAILURE; KIDNEY FUNCTION; KIDNEY TRANSPLANTATION; METABOLIC SYNDROME X; MORBIDITY; PATHOPHYSIOLOGY; PERITONEAL DIALYSIS; PROTEIN RESTRICTION; QUALITY OF LIFE; RANDOMIZED CONTROLLED TRIAL (TOPIC); RENAL REPLACEMENT THERAPY; REVIEW; RISK FACTOR;

EID: 84885109647     PISSN: 1745509X     EISSN: 17455103     Source Type: Journal    
DOI: 10.2217/ahe.13.52     Document Type: Review

References (203)

1. Mignon F, Michel C, Mentre F, Viron B. Worldwide demographics and future trends of the management of renal failure in the elderly. Kidney Int. Suppl. 41, S18-S26 (1993
2. CDC. Trends in aging-United States and worldwide. MMWR Morb. Mort. Wkly Rep. 52(6), 101-104, 106 (2003
3. Levey AS, Stevens LA, Coresh J. Conceptual model of CKD: Applications and implications. Am. J. Kidney Dis. 53(3 Suppl. 3), S4-S16 (2009
4. Roderick PJ, Atkins RJ, Smeeth L et al. CKD and mortality risk in older people: A community-based population study in the United Kingdom. Am. J. Kidney Dis. 53(6), 950-960 (2009
5. Stevens LA, Viswanathan G, Weiner DE. Chronic kidney disease and end-stage renal disease in the elderly population: Current prevalence, future projections, and clinical significance. Adv. Chronic Kidney Dis. 17(4), 293-301 (2010
6. Winchester JF, Rakowski TA. End-stage renal disease and its management in older adults. Clin. Geriatr. Med. 14(2), 255-265 (1998
7. Levin A, Stevens PE. Summary of KDIGO guideline: Behind the scenes, need for guidance, and a framework for moving forward. Kidney Int. doi:10.1038/ki.2013.192 (2013) (Epub ahead of print
8. Collins AJ, Foley R, Herzog C et al. Excerpts from the United States Renal Data System 2007 annual data report. Am. J. Kidney Dis. 51(1 Suppl. 1), S1-S320 (2008
9. Iseki K, Tozawa M, Iseki C, Takishita S, Ogawa Y. Demographic trends in the Okinawa Dialysis Study (OKIDS) registry (1971-2000). Kidney Int. 61(2), 668-675 (2002
10. Holley JL. Age, eGFR, and CKD complications. Clin. J. Am. Soc. Nephrol. 6(12), 2729-2731 (2011
11. Eggers PW. The aging pandemic: Demographic changes in the general and end-stage renal disease populations. Semin. Nephrol. 29(6), 551-554 (2009
12. Coresh J, Selvin E, Stevens LA et al. Prevalence of chronic kidney disease in the United States. JAMA 298(17), 2038-2047 (2007
13. Kurella Tamura M. Incidence, management, and outcomes of end-stage renal disease in the elderly. Curr. Opin. Nephrol. Hypertens. 18(3), 252-257 (2009
14. Mau LW, Liu J, Qiu Y et al. Trends in patient characteristics and first-year medical costs of older incident hemodialysis patients, 1995-2005. Am. J. Kidney Dis. 55(3), 549-557 (2010
15. Glassock RJ, Rule AD. The implications of anatomical and functional changes of the aging kidney: With an emphasis on the glomeruli. Kidney Int. 82(3), 270-277 (2012
16. Kaplan C, Pasternack B, Shah H, Gallo G. Age-related incidence of sclerotic glomeruli in human kidneys. Am. J. Pathol. 80(2), 227-234 (1975
17. Rule AD, Amer H, Cornell LD et al. The association between age and nephrosclerosis on renal biopsy among healthy adults. Ann. Intern. Med. 152(9), 561-567 (2010
18. Rule AD, Semret MH, Amer H et al. Association of kidney function and metabolic risk factors with density of glomeruli on renal biopsy samples from living donors. Mayo Clin. Proc. 86(4), 282-290 (2011
19. Rowe JW, Andres R, Tobin JD, Norris AH, Shock NW. The effect of age on creatinine clearance in men: A cross-sectional and longitudinal study. J. Gerontol. 31(2), 155-163 (1976
20. Fliser D, Franek E, Ritz E. Renal function in the elderly-is the dogma of an inexorable decline of renal function correct? Nephrol. Dial. Transplant. 12(8), 1553-1555 (1997
21. Fliser D. Ren sanus in corpore sano: The myth of the inexorable decline of renal function with senescence. Nephrol. Dial. Transplant. 20(3), 482-485 (2005
22. Choudhury D, Levi M. Kidney aging-inevitable or preventable? Nat. Rev. Nephrol. 7(12), 706-717 (2011
23. Levey AS, Stevens LA, Schmid CH et al. A new equation to estimate glomerular filtration rate. Ann. Intern. Med. 150(9), 604-612 (2009
24. Gaspari F, Ruggenenti P, Porrini E et al. The GFR and GFR decline cannot be accurately estimated in Type 2 diabetics. Kidney Int. 84(1), 164-173 (2013
25. Glassock RJ. Estimated glomerular filtration rate: Time for a performance review? Kidney Int. 75(10), 1001-1003 (2009
26. Schaeffner ES, Van Der Giet M, Gaedeke J et al. The Berlin initiative study: The methodology of exploring kidney function in the elderly by combining a longitudinal and cross-sectional approach. Eur. J. Epidemiol. 25(3), 203-210 (2010
27. Gentile G, Trillini M. Chronic kidney disease and risk of mortality, cardiovascular events or end-stage renal disease in older patients with hypertension. Expert Rev. Cardiovasc. Ther. 10(10), 1213-1216 (2012
28. Van Pottelbergh G, Bartholomeeusen S, Buntinx F, Degryse J. The evolution of renal function and the incidence of end-stage renal disease in patients aged 50 years. Nephrol. Dial. Transplant. 27(6), 2297-2303 (2012
29. Stengel B, Metzger M, Froissart M et al. Epidemiology and prognostic significance of chronic kidney disease in the elderly-The Three-City prospective cohort study. Nephrol. Dial. Transplant. 26(10), 3286-3295 (2011
30. Toussaint ND, Lau KK, Strauss BJ, Polkinghorne KR, Kerr PG. Associations between vascular calcification, arterial stiffness and bone mineral density in chronic kidney disease. Nephrol. Dial. Transplant. 23(2), 586-593 (2008
31. Tracy RE, Ishii T. Hypertensive renovasculopathies and the rise of blood pressure with age in Japan and USA. Int. Urol. Nephrol. 32, 109-117 (2000
32. Heeneman S, Sluimer J, Daemen M. Angiotensin-converting enzyme and vascular remodeling. Circ. Res. 101, 441-454 (2007
33. Hill GS. Hypertensive nephrosclerosis. Curr. Opin. Nephrol. Hypertens 17(3), 266-270 (2008
34. Melsom T, Mathisen UD, Eilertsen BA et al. Physical exercise, fasting glucose, and renal hyperfiltration in the general population: The Renal Iohexol Clearance Survey in Tromso 6 (RENIS-T6). Clin. J. Am. Soc. Nephrol. 7(11), 1801-1810 (2012
35. Chagnac A, Weinstein T, Herman M, Hirsh J, Gafter U, Ori Y. The effects of weight loss on renal function in patients with severe obesity. J. Am. Soc. Nephrol. 14(6), 1480-1486 (2003
36. Hsu CY, McCulloch CE, Fan D, Ordonez JD, Chertow GM, Go AS. Community-based incidence of acute renal failure. Kidney Int. 72(2), 208-212 (2007
37. Coca SG. Acute kidney injury in elderly persons. Am. J. Kidney Dis. 56(1), 122-131 (2010
38. Lea JP. Metabolic syndrome, CKD progression, and death: The good, the bad, and the ugly. Clin. J. Am. Soc. Nephrol. 8(6), 893-895 (2013
39. Morley JE. The metabolic syndrome and aging. J. Gerontol. A Biol. Sci. Med. Sci. 59(2), M139-M142 (2004
40. Baylis C. Sexual dimorphism in the aging kidney: Differences in the nitric oxide system. Nat. Rev. Nephrol. 5(7), 384-396 (2009
41. Anderson S. Ageing and the renin-Angiotensin system. Nephrol. Dial. Transplant. 12(6), 1093-1094 (1997
42. Fox CS, Larson MG, Leip EP, Culleton B, Wilson PW, Levy D. Predictors of new-onset kidney disease in a community-based population. JAMA 291(7), 844-850 (2004
43. Vlassara H, Torreggiani M, Post JB, Zheng F, Uribarri J, Striker GE. Role of oxidants/inflammation in declining renal function in chronic kidney disease and normal aging. Kidney Int. Suppl. (114), S3-S11 (2009
44. Perico N, Remuzzi G, Benigni A. Aging and the kidney. Curr. Opin. Nephrol. Hypertens. 20(3), 312-317 (2011
45. Glassock RJ, Winearls C. Ageing and the glomerular filtration rate: Truths and consequences. Trans. Am. Clin. Climatol. Assoc. 120, 419-428 (2009
46. Ronco C, Haapio M, House AA, Anavekar N, Bellomo R. Cardiorenal syndrome. J. Am. Coll. Cardiol. 52(19), 1527-1539 (2008
47. Coresh J, Selvin E, Stevens LA et al. Prevalence of chronic kidney disease in the United States. JAMA 298(17), 2038-2047 (2007
48. Kurella Tamura M. Incidence, management, and outcomes of end-stage renal disease in the elderly. Curr. Opin. Nephrol. Hypertens. 18(3), 252-257 (2009
49. Mau LW, Liu J, Qiu Y et al. Trends in patient characteristics and first-year medical costs of older incident hemodialysis patients, 1995-2005. Am. J. Kidney Dis. 55(3), 549-557 (2010
50. Glassock RJ, Rule AD. The implications of anatomical and functional changes of the aging kidney: With an emphasis on the glomeruli. Kidney Int. 82(3), 270-277 (2012
51. Kaplan C, Pasternack B, Shah H, Gallo G. Age-related incidence of sclerotic glomeruli in human kidneys. Am. J. Pathol. 80(2), 227-234 (1975
52. Rule AD, Amer H, Cornell LD et al. The association between age and nephrosclerosis on renal biopsy among healthy adults. Ann. Intern. Med. 152(9), 561-567 (2010
53. Rule AD, Semret MH, Amer H et al. Association of kidney function and metabolic risk factors with density of glomeruli on renal biopsy samples from living donors. Mayo Clin. Proc. 86(4), 282-290 (2011
54. Rowe JW, Andres R, Tobin JD, Norris AH, Shock NW. The effect of age on creatinine clearance in men: A cross-sectional and longitudinal study. J. Gerontol. 31(2), 155-163 (1976
55. Fliser D, Franek E, Ritz E. Renal function in the elderly-is the dogma of an inexorable decline of renal function correct? Nephrol. Dial. Transplant. 12(8), 1553-1555 (1997
56. Fliser D. Ren sanus in corpore sano: The myth of the inexorable decline of renal function with senescence. Nephrol. Dial. Transplant. 20(3), 482-485 (2005
57. Choudhury D, Levi M. Kidney aging-inevitable or preventable? Nat. Rev. Nephrol. 7(12), 706-717 (2011
58. Levey AS, Stevens LA, Schmid CH et al. A new equation to estimate glomerular filtration rate. Ann. Intern. Med. 150(9), 604-612 (2009
59. Gaspari F, Ruggenenti P, Porrini E et al. The GFR and GFR decline cannot be accurately estimated in Type 2 diabetics. Kidney Int. 84(1), 164-173 (2013
60. Glassock RJ. Estimated glomerular filtration rate: Time for a performance review? Kidney Int. 75(10), 1001-1003 (2009
61. Schaeffner ES, Van Der Giet M, Gaedeke J et al. The Berlin initiative study: The methodology of exploring kidney function in the elderly by combining a longitudinal and cross-sectional approach. Eur. J. Epidemiol. 25(3), 203-210 (2010
62. Gentile G, Trillini M. Chronic kidney disease and risk of mortality, cardiovascular events or end-stage renal disease in older patients with hypertension. Expert Rev. Cardiovasc. Ther. 10(10), 1213-1216 (2012
63. Van Pottelbergh G, Bartholomeeusen S, Buntinx F, Degryse J. The evolution of renal function and the incidence of end-stage renal disease in patients aged 50 years. Nephrol. Dial. Transplant. 27(6), 2297-2303 (2012
64. Stengel B, Metzger M, Froissart M et al. Epidemiology and prognostic significance of chronic kidney disease in the elderly-The Three-City prospective cohort study. Nephrol. Dial. Transplant. 26(10), 3286-3295 (2011
65. Toussaint ND, Lau KK, Strauss BJ, Polkinghorne KR, Kerr PG. Associations between vascular calcification, arterial stiffness and bone mineral density in chronic kidney disease. Nephrol. Dial. Transplant. 23(2), 586-593 (2008
66. Tracy RE, Ishii T. Hypertensive renovasculopathies and the rise of blood pressure with age in Japan and USA. Int. Urol. Nephrol. 32, 109-117 (2000
67. Heeneman S, Sluimer J, Daemen M. Angiotensin-converting enzyme and vascular remodeling. Circ. Res. 101, 441-454 (2007
68. Hill GS. Hypertensive nephrosclerosis. Curr. Opin. Nephrol. Hypertens 17(3), 266-270 (2008
69. Melsom T, Mathisen UD, Eilertsen BA et al. Physical exercise, fasting glucose, and renal hyperfiltration in the general population: The Renal Iohexol Clearance Survey in Tromso 6 (RENIS-T6). Clin. J. Am. Soc. Nephrol. 7(11), 1801-1810 (2012
70. Chagnac A, Weinstein T, Herman M, Hirsh J, Gafter U, Ori Y. The effects of weight loss on renal function in patients with severe obesity. J. Am. Soc. Nephrol. 14(6), 1480-1486 (2003
71. Hsu CY, McCulloch CE, Fan D, Ordonez JD, Chertow GM, Go AS. Community-based incidence of acute renal failure. Kidney Int. 72(2), 208-212 (2007
72. Coca SG. Acute kidney injury in elderly persons. Am. J. Kidney Dis. 56(1), 122-131 (2010
73. Lea JP. Metabolic syndrome, CKD progression, and death: The good, the bad, and the ugly. Clin. J. Am. Soc. Nephrol. 8(6), 893-895 (2013
74. Morley JE. The metabolic syndrome and aging. J. Gerontol. A Biol. Sci. Med. Sci. 59(2), M139-M142 (2004
75. Baylis C. Sexual dimorphism in the aging kidney: Differences in the nitric oxide system. Nat. Rev. Nephrol. 5(7), 384-396 (2009
76. Anderson S. Ageing and the renin-Angiotensin system. Nephrol. Dial. Transplant. 12(6), 1093-1094 (1997
77. Fox CS, Larson MG, Leip EP, Culleton B, Wilson PW, Levy D. Predictors of new-onset kidney disease in a community-based population. JAMA 291(7), 844-850 (2004
78. Vlassara H, Torreggiani M, Post JB, Zheng F, Uribarri J, Striker GE. Role of oxidants/inflammation in declining renal function in chronic kidney disease and normal aging. Kidney Int. Suppl. (114), S3-S11 (2009
79. Perico N, Remuzzi G, Benigni A. Aging and the kidney. Curr. Opin. Nephrol. Hypertens. 20(3), 312-317 (2011
80. Glassock RJ, Winearls C. Ageing and the glomerular filtration rate: Truths and consequences. Trans. Am. Clin. Climatol. Assoc. 120, 419-428 (2009
81. Ronco C, Haapio M, House AA, Anavekar N, Bellomo R. Cardiorenal syndrome. J. Am. Coll. Cardiol. 52(19), 1527-1539 (2008
82. Santoro A. Heart failure and cardiorenal syndrome in the elderly. J. Nephrol. 25(Suppl. 19), S67-S72 (2012
83. Metra M, Cotter G, Gheorghiade M, Dei Cas L, Voors AA. The role of the kidney in heart failure. Eur. Heart J. 33(17), 2135-2142 (2012
84. Zoccali C, Leonardis D, Enia G et al. Heart rate, age and the risk of progression to kidney failure in patients with CKD. J. Nephrol. 25(Suppl. 19), S20-S27 (2012
85. Collins AJ, Foley RN, Chavers B et al. United States Renal Data System 2011 annual data report: Atlas of chronic kidney disease and end-stage renal disease in the United States. Am. J. Kidney Dis. 59(1 Suppl. 1), A7, e1-420 (2012
86. Villar E, Remontet L, Labeeuw M, Ecochard R. Effect of age, gender, and diabetes on excess death in end-stage renal failure. J. Am. Soc. Nephrol. 18(7), 2125-2134 (2007
87. Fried L, Tangen C, Walston J et al. Frailty in older adults: Evidence for a phenotype. J. Gerontol. A Biol. Sci. Med. Sci. 56(3), 146-156 (2001
88. Shlipak MG, Stehman-Breen C, Fried LF et al. The presence of frailty in elderly persons with chronic renal insufficiency. Am. J. Kidney Dis. 43(5), 861-867 (2004
89. Johansen KL, Chertow GM, Jin C, Kutner NG. Significance of frailty among dialysis patients. J. Am. Soc. Nephrol. 18(11), 2960-2967 (2007
90. Ortiz GG, Arias-Merino ED, Flores-Saiffe M et al. Prevalence of cognitive impairment and depression among a population aged over 60 years in the metropolitan area of Guadalajara, Mexico. Curr. Gerontol. Geriatr. Res. 6 2012, 175019 (2012
91. Katsikas JL, Nelson FV, Bacchus S, Nissenson AR. Opinion: Applying frail-elderly care principles. Semin. Dial. 22(1), 22-24 (2009
92. Abdel-Rahman EM, Turgut F, Turkmen K, Balogun RA. Falls in elderly hemodialysis patients. QJM 104(10), 829-838 (2011
93. Agborsangaya CB, Lau D, Lahtinen M, Cooke T, Johnson JA. Multimorbidity prevalence and patterns across socioeconomic determinants: A cross-sectional survey. BMC Public Health 12, 201 (2012
94. Levey AS, Stevens LA, Schmid CH et al. A new equation to estimate glomerular filtration rate. Ann. Intern. Med. 150(9), 604-612 (2009
95. Gaspari F, Ruggenenti P, Porrini E et al. The GFR and GFR decline cannot be accurately estimated in Type 2 diabetics. Kidney Int. 84(1), 164-173 (2013
96. Glassock RJ. Estimated glomerular filtration rate: Time for a performance review? Kidney Int. 75(10), 1001-1003 (2009
97. Schaeffner ES, Van Der Giet M, Gaedeke J et al. The Berlin initiative study: The methodology of exploring kidney function in the elderly by combining a longitudinal and cross-sectional approach. Eur. J. Epidemiol. 25(3), 203-210 (2010
98. Gentile G, Trillini M. Chronic kidney disease and risk of mortality, cardiovascular events or end-stage renal disease in older patients with hypertension. Expert Rev. Cardiovasc. Ther. 10(10), 1213-1216 (2012
99. Van Pottelbergh G, Bartholomeeusen S, Buntinx F, Degryse J. The evolution of renal function and the incidence of end-stage renal disease in patients aged 50 years. Nephrol. Dial. Transplant. 27(6), 2297-2303 (2012
100. Stengel B, Metzger M, Froissart M et al. Epidemiology and prognostic significance of chronic kidney disease in the elderly-The Three-City prospective cohort study. Nephrol. Dial. Transplant. 26(10)-, 3286-3295 (2011
101. Toussaint ND, Lau KK, Strauss BJ, Polkinghorne KR, Kerr PG. Associations between vascular calcification, arterial stiffness and bone mineral density in chronic kidney disease. Nephrol. Dial. Transplant. 23(2), 586-593 (2008
102. Tracy RE, Ishii T. Hypertensive renovasculopathies and the rise of blood pressure with age in Japan and USA. Int. Urol. Nephrol. 32, 109-117 (2000
103. Heeneman S, Sluimer J, Daemen M. Angiotensin-converting enzyme and vascular remodeling. Circ. Res. 101, 441-454 (2007
104. Hill GS. Hypertensive nephrosclerosis. Curr. Opin. Nephrol. Hypertens 17(3), 266-270 (2008
105. Melsom T, Mathisen UD, Eilertsen BA et al. Physical exercise, fasting glucose, and renal hyperfiltration in the general population: The Renal Iohexol Clearance Survey in Tromso 6 (RENIS-T6). Clin. J. Am. Soc. Nephrol. 7(11), 1801-1810 (2012
106. Chagnac A, Weinstein T, Herman M, Hirsh J, Gafter U, Ori Y. The effects of weight loss on renal function in patients with severe obesity. J. Am. Soc. Nephrol. 14(6), 1480-1486 (2003
107. Hsu CY, McCulloch CE, Fan D, Ordonez JD, Chertow GM, Go AS. Community-based incidence of acute renal failure. Kidney Int. 72(2), 208-212 (2007
108. Coca SG. Acute kidney injury in elderly persons. Am. J. -Kidney Dis. 56(1), 122-131 (2010
109. Lea JP. Metabolic syndrome, CKD progression, and death: The good, the bad, and the ugly. Clin. J. Am. Soc. Nephrol. 8(6), 893-895 (2013
110. Morley JE. The metabolic syndrome and aging. J. Gerontol. A Biol. Sci. Med. Sci. 59(2), M139-M142 (2004
111. Baylis C. Sexual dimorphism in the aging kidney: Differences in the nitric oxide system. Nat. Rev. Nephrol. 5(7), 384-396 (2009
112. Anderson S. Ageing and the renin-Angiotensin system. Nephrol. Dial. Transplant. 12(6), 1093-1094 (1997
113. Fox CS, Larson MG, Leip EP, Culleton B, Wilson PW, Levy D. Predictors of new-onset kidney disease in a community-based population. JAMA 291(7), 844-850 (2004
114. Vlassara H, Torreggiani M, Post JB, Zheng F, Uribarri J, Striker GE. Role of oxidants/inflammation in declining renal function in chronic kidney disease and normal aging. Kidney Int. Suppl. (114), S3-S11 (2009
115. Perico N, Remuzzi G, Benigni A. Aging and the kidney. Curr. Opin. Nephrol. Hypertens. 20(3), 312-317 (2011
116. Glassock RJ, Winearls C. Ageing and the glomerular filtration rate: Truths and consequences. Trans. Am. Clin. Climatol. Assoc. 120, 419-428 (2009
117. Ronco C, Haapio M, House AA, Anavekar N, Bellomo R. Cardiorenal syndrome. J. Am. Coll. Cardiol. 52(19), 1527-1539 (2008
118. Santoro A. Heart failure and cardiorenal syndrome in the elderly. J. Nephrol. 25(Suppl. 19), S67-S72 (2012
119. Metra M, Cotter G, Gheorghiade M, Dei Cas L, Voors AA. The role of the kidney in heart failure. Eur. Heart J. 33(17), 2135-2142 (2012
120. Zoccali C, Leonardis D, Enia G et al. Heart rate, age and the risk of progression to kidney failure in patients with CKD. J. Nephrol. 25(Suppl. 19), S20-S27 (2012
121. Collins AJ, Foley RN, Chavers B et al. United States Renal Data System 2011 annual data report: Atlas of chronic kidney disease and end-stage renal disease in the United States. Am. J. Kidney Dis. 59(1 Suppl. 1), A7, e1-420 (2012
122. Villar E, Remontet L, Labeeuw M, Ecochard R. Effect of age, gender, and diabetes on excess death in end-stage renal failure. J. Am. Soc. Nephrol. 18(7), 2125-2134 (2007
123. Fried L, Tangen C, Walston J et al. Frailty in older adults: Evidence for a phenotype. J. Gerontol. A Biol. Sci. Med. Sci. 56(3), 146-156 (2001
124. Shlipak MG, Stehman-Breen C, Fried LF et al. The presence of frailty in elderly persons with chronic renal insufficiency. Am. J. Kidney Dis. 43(5), 861-867 (2004
125. Johansen KL, Chertow GM, Jin C, Kutner NG. Significance of frailty among dialysis patients. J. Am. Soc. Nephrol. 18(11), 2960-2967 (2007
126. Ortiz GG, Arias-Merino ED, Flores-Saiffe M et al. Prevalence of cognitive impairment and depression among a population aged over 60 years in the metropolitan area of Guadalajara, Mexico. Curr. Gerontol. Geriatr. Res. 6 2012, 175019 (2012
127. Katsikas JL, Nelson FV, Bacchus S, Nissenson AR. Opinion: Applying frail-elderly care principles. Semin. Dial. 22(1), 22-24 (2009
128. Abdel-Rahman EM, Turgut F, Turkmen K, Balogun RA. Falls in elderly hemodialysis patients. QJM 104(10), 829-838 (2011
129. Agborsangaya CB, Lau D, Lahtinen M, Cooke T, Johnson JA. Multimorbidity prevalence and patterns across socioeconomic determinants: A cross-sectional survey. BMC Public Health 12, 201 (2012
130. Quiñones AR, Liang J, Bennett JM, Xu X, Ye W. How does the trajectory of multimorbidity vary across black, white, and Mexican-Americans in middle and old age? J. Gerontol. B Psychol. Sci. Soc. Sci. 66(6), 739-749 (2011
131. Schuling J, Gebben H, Veehof LJ, Haaijer-Ruskamp FM. Deprescribing medication in very elderly patients with multimorbidity: The view of Dutch GPs. A qualitative study. BMC Fam. Pract. 13, 56 (2012
132. Myers OB, Adams C, Rohrscheib MR et al. Age, race, diabetes, blood pressure, and mortality among hemodialysis patients. J. Am. Soc. Nephrol. 21(11), 1970-1978 (2010
133. Fried L, Ferrucci L, Darer J, Williamson J, Anderson G. Untangling the concepts of disability, frailty, and comorbidity: Implications for improved targeting and care. J. Gerontol. A Biol. Sci. Med. Sci. 59(3), 255-263 (2004
134. Reboldi G, Gentile G, Angeli F, Verdecchia P. Blood pressure lowering in the oldest old. J. Hypertens. 28(7), 1373-1376 (2010
135. Law MR, Morris JK, Wald NJ. Use of blood pressure lowering drugs in the prevention of cardiovascular disease: Meta-Analysis of 147 randomised trials in the context of expectations from prospective epidemiological studies. BMJ 338, b1665 (2009
136. Beckett NS, Peters R, Fletcher AE et al. Treatment of hypertension in patients 80 years of age or older. N. Engl. J. Med. 358(18), 1887-1898 (2008
137. Staessen JA, Fagard R, Thijs L et al. Randomised double-blind comparison of placebo and active treatment for older patients with isolated systolic hypertension. The Systolic Hypertension in Europe (Syst-Eur) Trial Investigators. Lancet 350(9080), 757-764 (1997
138. Turnbull F, Neal B, Ninomiya T et al.; Blood Pressure Lowering Treatment Trialists' Collaboration. Effects of different regimens to lower blood pressure on major cardiovascular events in older and younger adults: Meta-Analysis of randomised trials. BMJ 336(7653), 1121-1123 (2008
139. Grossman E, Verdecchia P, Shamiss A, Angeli F, Reboldi G. Diuretic treatment of hypertension. Diabetes Care 34(Suppl. 2),S313'S319 (2011).
140. Beckett NS, Peters R, Fletcher AE et al. Treatment of hypertension in patients 80 years of age or older. N. Engl. J. Med. 358(18), 1887-1898 (2008
141. Staessen JA, Fagard R, Thijs L et al. Randomised double-blind comparison of placebo and active treatment for older patients with isolated systolic hypertension. The Systolic Hypertension in Europe (Syst-Eur) Trial Investigators. Lancet 350(9080), 757-764 (1997
142. Turnbull F, Neal B, Ninomiya T et al.; Blood Pressure Lowering Treatment Trialists' Collaboration. Effects of different regimens to lower blood pressure on major cardiovascular events in older and younger adults: Meta-Analysis of randomised trials. BMJ 336(7653), 1121-1123 (2008
143. Grossman E, Verdecchia P, Shamiss A, Angeli F, Reboldi G. Diuretic treatment of hypertension. Diabetes Care 34(Suppl. 2), S313-S319 (2011
144. Rahman M, Ford CE, Cutler JA et al. Long-Term renal and cardiovascular outcomes in Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial (ALLHAT) participants by baseline estimated GFR. Clin. J. Am. Soc. Nephrol. 7(6), 989-1002 (2012
145. National Kidney Foundation. K/DOQI clinical practice guidelines for chronic kidney disease: Evaluation, classification, and stratification. Am. J. Kidney Dis. 39(2 Suppl. 1), S1-S266 (2002
146. Dasgupta I, Rayner HC. In good conscience-safely withholding dialysis in the elderly. Semin. Dial. 22(5), 476-479 (2009
147. Noble H. Supportive and palliative care for the patient with end-stage renal disease. Br. J. Nurs. 17(8), 498-504 (2008
148. Berzoff J, Swantkowski J, Cohen LM. Developing a renal supportive care team from the voices of patients, families, and palliative care staff. Palliat. Support Care 6(2), 133-139 (2008
149. Carson RC, Juszczak M, Davenport A, Burns A. Is maximum conservative management an equivalent treatment option to dialysis for elderly patients with significant comorbid disease? Clin. J. Am. Soc. Nephrol. 4(10), 1611-1619 (2009
150. Murtagh FE, Cohen LM, Germain MJ. The no dialysis' option. Adv. Chronic Kidney Dis. 18(6), 443-449 (2011
151. Swidler M. Chapter 37. Dialysis decisions in the elderly patient with advanced CKD and the role of nondialytic therapy. In: American Society of Nephrology Geriatric Nephrology Curriculum. Oreopoulos D, Wiggins J (Eds). American Society of Nephrology, Washington, DC, USA, 1-7 (2009
152. Wong CF, McCarthy M, Howse ML, Williams PS. Factors affecting survival in advanced chronic kidney disease patients who choose not to receive dialysis. Ren. Fail. 29(6), 653-659 (2007
153. Brunori G, Viola BF, Parrinello G et al. Efficacy and safety of a very-low-protein diet when postponing dialysis in the elderly: A prospective randomized multicenter controlled study. Am. J. Kidney Dis. 49(5), 569-580 (2007
154. Brunori G. Treatment of chronic kidney disease in the elderly: Diet or conservative management. J. Nephrol. 25(Suppl. 19), S28-S31 (2012
155. Bruce DG, St John A, Nicklason F, Goldswain PR. Secondary hyperparathyroidism in patients from western Australia with hip fracture: Relationship to type of hip fracture, renal function, and vitamin D deficiency. J. Am. Geriatr. Soc. 47(3), 354-359 (1999
156. Lips P. Vitamin D deficiency and secondary hyperparathyroidism in the elderly: Consequences for bone loss and fractures and therapeutic implications. Endocr. Rev. 22(4), 477-501 (2001
157. Levin A, Bakris GL, Molitch M et al. Prevalence of abnormal serum vitamin D, PTH, calcium, and phosphorus in patients with chronic kidney disease: Results of the study to evaluate early kidney disease. Kidney Int. 71(1), 31-38 (2007
158. Rix M, Andreassen H, Eskildsen P, Langdahl B, Olgaard K. Bone mineral density and biochemical markers of bone turnover in patients with predialysis chronic renal failure. Kidney Int. 56(3), 1084-1093 (1999
159. Go AS, Chertow GM, Fan D, McCulloch CE, Hsu CY. Chronic kidney disease and the risks of death, cardiovascular events, and hospitalization. N. Engl. J. Med. 351(13), 1296-1305 (2004
160. Ye X, Rastogi A, Nissenson AR. Renal replacement therapy in the elderly. Clin. Geriatr. Med. 25(3), 529-542 (2009
161. Letourneau I, Ouimet D, Dumont M, Pichette V, Leblanc M. Renal replacement in end-stage renal disease patients over 75 years old. Am. J. Nephrol. 23(2), 71-77 (2003
162. Jassal SV, Chiu E, Hladunewich M. Loss of independence in patients starting dialysis at 80 years of age or older. N. Engl. J. Med. 361(16), 1612-1613 (2009
163. De Biase V, Tobaldini O, Boaretti C et al. Prolonged conservative treatment for frail elderly patients with end-stage renal disease: The Verona experience. Nephrol. Dial. Transplant. 23(4), 1313-1317 (2008
164. Murtagh FE, Marsh JE, Donohoe P, Ekbal NJ, Sheerin NS, Harris FE. Dialysis or not? A comparative survival study of patients over 75 years with chronic kidney disease stage 5. Nephrol. Dial. Transplant. 22(7), 1955-1962 (2007
165. Chandna SM, Da Silva-Gane M, Marshall C, Warwicker P, Greenwood RN, Farrington K. Survival of elderly patients with stage 5 CKD: Comparison of conservative management and renal replacement therapy. Nephrol. Dial. Transplant. 26(5), 1608-1614 (2011
166. Smith C, Da Silva-Gane M, Chandna S, Warwicker P, Greenwood R, Farrington K. Choosing not to dialyse: Evaluation of planned non-dialytic management in a cohort of patients with end-stage renal failure. Nephron Clin. Pract. 95(2), c40-c46 (2003
167. Joly D, Anglicheau D, Alberti C et al. Octogenarians reaching end-stage renal disease: Cohort study of decision-making and clinical outcomes. J. Am. Soc. Nephrol. 14(4), 1012-1021 (2003
168. Genestier S, Meyer N, Chantrel F et al. Prognostic survival factors in elderly renal failure patients treated with peritoneal dialysis: A nine-year retrospective study. Perit. Dial. Int. 30(2), 218-226 (2010
169. Selgas R, Cirugeda A, Fernandez-Perpen A et al. Comparisons of hemodialysis and CAPD in patients over 65 years of age: A meta-Analysis. Int. Urol. Nephrol. 33(2), 259-264 (2001
170. Vonesh EF, Snyder JJ, Foley RN, Collins AJ Mortality studies comparing peritoneal dialysis and hemodialysis: What do they tell us? Kidney Int. Suppl. (103), S3-S11 (2006
171. Saxena R, Yu X, Giraldo M et al. Renal transplantation in the elderly. Int. Urol. Nephrol. 41(1), 195-210 (2009
172. Cravedi P, Ruggenenti P, Remuzzi G Old donors for kidney transplantation: How old? Gerontology 57(6), 513-520 (2011
173. Otero-Ravina F, Rodriguez-Martinez M, Gude F, Gonzalez-Juanatey JR, Valdes F, Sanchez-Guisande D. Renal transplantation in the elderly: Does patient age determine the results? Age Ageing 34(6), 583-587 (2005
174. Couchoud C, Moranne O, Frimat L, Labeeuw M, Allot V, Stengel B. Associations between comorbidities, treatment choice and outcome in the elderly with end-stage renal disease. Nephrol. Dial. Transplant. 22(11), 3246-3254 (2007
175. Heldal K, Hartmann A, Grootendorst DC et al. Benefit of kidney transplantation beyond 70 years of age. Nephrol. Dial. Transplant. 25(5), 1680-1687 (2010
176. Rebollo P, Ortega F, Baltar JM et al. Health-related quality of life (HRQOL) in end stage renal disease (ESRD) patients over 65 years. Geriatr. Nephrol. Urol. 8(2), 85-94 (1998
177. Dousdampanis P, Trigka K, Fourtounas C. Diagnosis and management of chronic kidney disease in the elderly: A field of ongoing debate. Aging Dis. 3(5), 360-372 (2012
178. Hubbard WJ, Dashti N. Aging and transplantation-A topic for biomedicine or bioethics? Aging Dis. 2(2), 181-185 (2011
179. Remuzzi G, Cravedi P, Perna A et al. Long-Term outcome of renal transplantation from older donors. N. Engl. J. Med. 354(4), 343-352 (2006
180. McKay D, Jameson J. Kidney transplantation and the ageing immune system. Nat. Rev. Nephrol. 8(12), 700-708 (2012
181. Tullius SG, Tran H, Guleria I, Malek SK, Tilney NL, Milford E. The combination of donor and recipient age is critical in determining host immunoresponsiveness and renal transplant outcome. Ann. Surg. 252(4), 662-674 (2010
182. Tullius SG, Milford E. Kidney allocation and the aging immune response. N. Engl. J. Med. 364(14), 1369-1370 (2011
183. Lim WH, Dogra G, Chadban SJ et al. Lack of impact of donor age on patient survival for renal transplant recipients 60 years. Transpl. Int. 25(4), 401-408 (2012
184. Frei U, Noeldeke J, Machold-Fabrizii V et al. Prospective age-matching in elderly kidney transplant recipients-A 5 year analysis of the Eurotransplant Senior Program. Am. J. Transplant. 8(1), 50-57 (2008
185. Pratschke J, Merk V, Reutzel-Selke A et al. Potent early immune response after kidney transplantation in patients of the European senior transplant program. Transplantation 87(7), 992-1000 (2009
186. Ahmed S, Addicott C, Qureshi M, Pendleton N, Clague JE, Horan MA. Opinions of elderly people on treatment for end-stage renal disease. Gerontology 45(3), 156-159 (1999
187. Davison SN. End-of-life care preferences and needs: Perceptions of patients with chronic kidney disease. Clin. J. Am. Soc. Nephrol. 5(2), 195-204 (2010
188. Stringer S, Baharani J. Why did I start dialysis? A qualitative study on views and expectations from an elderly cohort of patients with end-stage renal failure starting haemodialysis in the United Kingdom. Int. Urol. Nephrol. 44(1), 295-300 (2012
189. Visser A, Dijkstra GJ, Kuiper D et al. Accepting or declining dialysis: Considerations taken into account by elderly patients with end-stage renal disease. J. Nephrol. 22(6), 794-799 (2009
190. Brown EA, Johansson L. Epidemiology and management of end-stage renal disease in the elderly. Nat. Rev. Nephrol. 7(10), 591-598 (2011
191. Brown EA, Johansson L, Farrington K et al. Broadening options for long-Term dialysis in the elderly (BOLDE): Differences in quality of life on
192. Thorsteinsdottir B, Swetz KM, Feely MA, Mueller PS, Williams AW. Are there alternatives to hemodialysis for the elderly patient with end-stage renal failure? Mayo Clin. Proc. 87(6), 514-516 (2012
193. Intiso D, Di Rienzo F, Russo M et al. Rehabilitation strategy in the elderly. J. Nephrol. 25(Suppl. 19), S90-S95 (2012
194. Del Vecchio L, Locatelli F. Ethical considerations in nephro-geriatrics. J. Nephrol. 25(Suppl. 19), S6-S10 (2012
195. Galla J. Clinical practice guideline on shared decision-making in the appropriate initiation of and withdrawal from dialysis. J. Am. Soc. Nephrol. 11(7), 1340-1342 (2000
196. Germain MJ, Davison SN, Moss AH. When enough is enough: The nephrologist's responsibility in ordering dialysis treatments. Am. J. Kidney Dis. 58(1), 135-143 (2011
197. Renal Physicians Association. Shared Decision-Making in the Appropriate Initiation of and Withdrawal from Dialysis. Clinical Practice Guideline (2nd edition). Renal Physicians Association National Office, Rockville, MD, USDA (2010
198. Germain MJ, Cohen LM, Davison SN. Withholding and withdrawal from dialysis: What we know about how our patients die. Semin. Dial. 20(3), 195-199 (2007
199. Greco A, Cascavilla L, Paris F et al. The nephro-geriatric unit in a lean-oriented in-hospital model of care. J. Nephrol. 25(Suppl. 19), S16-S19 (2012
200. Older Americans 2008. Key indicators of well-being (2008). www.agingstats.gov/agingstatsdotnet/Main- Site/Data/2008-Documents/OA-2008.pdf (Accessed 28 August 2013
201. United Nations Publications. Department of Economic and Social Affairs. World population ageing 2009. www.un.org/esa/population/publications/ WPA2009/WPA2009-WorkingPaper.pdf (Accessed 11 September 2013
202. American Geriatrics Society Expert Panel on the Care of Older Adults with Multimorbidity. Guiding principles for the care of older adults with multimorbidity (2012). www.americangeriatrics.org/files/documents/ MCC.principles.pdf (Accessed 1 August 2013
203. US Renal Data System. Annual data report (2012