Renal replacement therapy in patients aged over 60 years

Abstract

The availability of dialysis for patients with end-stage renal failure in the United Kingdom haslagged behind that in most of the rest of Europe and USA, although there has been considerable improvementover recent years. Concern about prognosis and quality of life on renal replacement therapy, together withshortage of facilities has meant that some elderly people have been denied treatment.A retrospective study of all patients commencing renal replacement therapy in Newcastle between 1974and 1985 was performed. The five year survival of patients aged more than 60 years at the start oftreatment (n = 122) was 53%, compared with 68% for a cohort of individuals aged less than 60 years(n = 632).A questionnaire sent to the 62 elderly patients surviving at the end of the follow-up period revealed thatmost were married, independent, active and lived in their own home. They were not lonely, generallyenjoyed life and were happy with their mode of renal replacement therapy.These results show that elderly patients make good dialysis candidates and they should not be deniedtreatment on the basis of age alone. Greater funding of renal services is necessary to accommodate these patients. © The Fellowship of Postgraduate Medicine, 1987.