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Chronic kidney disease in older people

Published online by Cambridge University Press:  19 July 2013

AH Abdelhafiz ,
C Bailey ,
J Russell  and
M El Nahas
AH Abdelhafiz*
Affiliation:
Department of Elderly Medicine, Rotherham General Hospital, Rotherham
C Bailey
Affiliation:
Department of Elderly Medicine, Rotherham General Hospital, Rotherham
J Russell
Affiliation:
Department of Elderly Medicine, Rotherham General Hospital, Rotherham
M El Nahas
Affiliation:
Sheffield Kidney Institute, Sheffield, UK
*
Address for correspondence: Dr Ahmed H. Abdelhafiz, Department of Elderly Medicine, Rotherham General Hospital, Moorgate Road, RotherhamS60 2UD. Email: [email protected]
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Summary

Chronic kidney disease prevalence will continue to rise due to increased life expectancy and population ageing. It is likely that the decline in glomerular filtration rate with increasing age represents a renal manifestation of widespread vascular disease. In addition to its associated cardiovascular risk, chronic kidney disease in older people is associated with increased prevalence of geriatric syndromes such as functional and cognitive decline, which lead to disability and frailty. Competing risks for mortality, because of the co-existence of multiple co-morbidities in old age, means that the majority of older people with chronic kidney disease will not progress to end-stage renal disease. Management of chronic kidney disease in older people is complex and an individualized and holistic, rather than disease-orientated, approach is necessary, which takes into account patients’ priorities and wishes, especially frail and very elderly populations with multiple co-morbidities.

Keywords

chronic kidney diseaseglomerular filtration raterenal replacement therapy
Type
Review Article
Information
Reviews in Clinical Gerontology , Volume 23 , Issue 3 , August 2013 , pp. 177 - 188
Copyright
Copyright © Cambridge University Press 2013 

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