The characteristics of the older dialysis population - Heterogeneity and another type of altered risk factor patterns

Abstract

The number of older dialysis patients is increasing in many countries. For example, the trend is linked to the increase in the dialysis patients 70 years of age and over in Japan. Older dialysis patients often experience deteriorating physical and psychological functions, and special consideration for older patients has been focused on improving or preventing such deteriorations. On the other hand, from the standpoint of clinical studies, the distribution of clinical parameters, clinical outcomes, and their associations of older dialysis patients differ from those of younger patients. Moreover, they exhibit heterogeneous phenotypes. Health age may be more important than the chronological age in considering older patients. Since the age is the most powerful predictor of survival, clinical interventions might have little benefit on the very old dialysis patients. Therefore, maintaining the quality of life or activity of daily living might surpass survival regarding the goal of management of very old dialysis patients. Above all, individualized management according to the heterogeneity or health age are necessary for the older dialysis patients. Future clinical studies of older dialysis patients are needed for the better understanding of this population.