| Theme |
Reconsidering dialysis initiation for the elderly |
| Title |
Clinical course of elderly patients with advanced chronic kidney disease and influential factors not to dialyse |
| Author |
Masaaki Nakayama |
Department of Nephrology, Hypertension, Diabetology, Endocrinology and Metabolism, Fukushima Medical University, School of Medicine |
| Author |
Kenichi Tanaka |
Department of Nephrology, Hypertension, Diabetology, Endocrinology and Metabolism, Fukushima Medical University, School of Medicine |
| Author |
Tae Yamamoto |
Division of Nephrology, Endocrinology and Vascular Medicine, Tohoku University Graduate School of Medicine |
| Author |
Mariko Miyazaki |
Division of Nephrology, Endocrinology and Vascular Medicine, Tohoku University Graduate School of Medicine |
| Author |
Atsuhiro Kanno |
Kidney Center, JCHO Sendai Hospital |
| Author |
Toshinobu Sato |
Kidney Center, JCHO Sendai Hospital |
| [ Summary ] |
Given the poor prognosis of elderly chronic kidney disease patients, therapeutic strategies to maintain adequate nutrition and activities of daily living are essential for these patients. While dialysis therapy reportedly does not benefit extremely frail patients in terms of prolonging survival or maintaining performance status, the possibility of dialysis still should be introduced and discussed with these patients, given the evolving concepts of patient-centered care, and shared decision-making. For those who choose conservative therapy, palliative care should be pursued to preserve patients' dignity and quality of life, which are crucial issues in Japan. |