Jul 24, 2007 - keywords chronic kidney disease, conservative management ... from four UK renal units. ... Diet in Renal Disease equation) upon initial presen-.
P r ac t i c e p o i n t www.nature.com/clinicalpractice/neph
Dialysis versus conservative management of elderly patients with advanced chronic kidney disease Original article Murtagh FEM et al. (2007) Dialysis or not?
A comparative survival study of patients over 75 years with chronic kidney disease stage 5. Nephrol Dial Transplant 22: 1955–1962
S Y NO P S I S keywords chronic kidney disease, conservative management, dialysis, elderly, survival
BACKGROUND
Few data are available on the factors that influence the decision of whether or not to start dialysis, which can be particularly difficult in older patients. OBJECTIVES
To compare survival rates in elderly patients with stage 5 chronic kidney disease (CKD) managed with dialysis or conservative treatment, and to pinpoint variables associated with survival in this population. DESIGN AND INTERVENTION
This study was a retrospective review of data from four UK renal units. Patients aged >75 years who received dedicated multidisciplinary predialysis care between 1 September 2003 and 31 August 2004 were included. Multidisciplinary care is indicated for patients who are anticipated to need dialysis within 18 months, excluding those who have presented late with CKD or who have experienced a sudden unexpected decline in renal function. Exclusion criteria for this analysis were glomerular filtration rate (GFR)
