An approach to treating older adults with chronic kidney disease

Chronic kidney disease (CKD) in older adults is a worldwide epidemic that affects nearly 40% of people aged 65 or older. In the US, CKD in people aged 65 years and older is more common (38%) than in all other age groups. Over the last 4 decades, patients older than 75 years are the fastest-growing g...

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Bibliographic Details
Published in:Canadian Medical Association journal (CMAJ) 2023-05, Vol.195 (17), p.E612-E618
Main Authors: Merchant, Asad Ali, Ling, Erick
Format: Article
Language:English
Subjects:
Age
Aged
Aged patients
Blood pressure
Cardiovascular disease
Care and treatment
Causes of
Chronic kidney failure
Creatinine
Denosumab
Diabetes
Diagnosis
Diuretics
Evidence-based medicine
Frailty
Glucose
Humans
Hyperkalemia
Hypertension
Hypotension
Kidney diseases
Laxatives
Linaclotide
Lubiprostone
Nephrology
Nonsteroidal anti-inflammatory drugs
Older people
Polypharmacy
Potassium
Renal Insufficiency, Chronic
Review
Risk factors
Sodium
Systemic diseases
Type 2 diabetes
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Summary:Chronic kidney disease (CKD) in older adults is a worldwide epidemic that affects nearly 40% of people aged 65 or older. In the US, CKD in people aged 65 years and older is more common (38%) than in all other age groups. Over the last 4 decades, patients older than 75 years are the fastest-growing group to start dialysis. In Canada, more than half of patients starting dialysis are 65 years or older. KD confers considerable morbidity on patients and consumes a substantial amount of health care resources. Few evidence-based guidelines specifically speak to management of CKD in older adults, many of whom are frail and have multiple comorbidities, and physicians should exercise caution when extrapolating general guidelines to older adults. Here, Merchant and Ling discuss the causes and consequences of CKD through a geriatric lens, and outlines principles of best practice.
ISSN:0820-3946
1488-2329
DOI:10.1503/cmaj.221427