Authors: Del Vecchio L, Locatelli F
Abstract
Life expectancy and quality of life may be rather poor in elderly patients with chronic kidney disease stage V. This raises a number of issues surrounding the decision of whether or not to commence renal replacement therapy and about the right timing of this. Those starting dialysis appear to have a better outcome; however, important selection bias is very likely and the survival advantage offered by dialysis is markedly reduced in patients with severe comorbidities. Moreover, those commencing dialysis are more likely to be hospitalized than those managed conservatively. Cognitive impairment, dependence on daily activities, comorbidities, and life expectancy are relevant factors that need to be considered in order to decide whether or no...