Renal replacement therapy in elderly CKD patients

The incidence of chronic kidney disease and end stage renal disease (ESRD) is increasing in the elderly, worldwide. Hemodialysis, peritoneal dialysis and renal transplantation are different modalities of renal replacement therapy employed for elderly ESRD patients. Vascular access problems are more common in the elderly patients. The survival outcomes are similar and poor among elderly hemodialysis and peritoneal dialysis patients, although only few studies hint at higher mortality in elderly diabetic patients on peritoneal dialysis. Renal transplantation in selected patients appears to be beneficial. Dialysis refusal or withdrawal by patients is also an important issue in elderly ESRD patients.