La dialyse après 75 ans : particularités et enjeux

Over the last ten years, the incidence of elderly patients who have started dialysis has increased. However, the management of the elderly patient suffering from end stage renal disease involves specificities closely related to age. In the elderly, renal insufficiency reveals the global ageing of other organs. Comorbidities increase in the elderly, in whom we observe more frequently impaired quality of life and death. Dialysis is not sufficient to avoid this global decline. Dialysis in the elderly is the opportunity to develop individualised care. It is necessary to define early on a strategy that includes objectives of care, limits of dialysis, and parameters of follow-up. It is important to integrate elderly patients in care and decisions. They need clear information on treatment and prognosis. The main challenge is the development of tools to predict evolution and prognosis in dialysis, in order to deliver accurate and loyal information.