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Inicio Medicina Clínica (English Edition) Shared decision-making in advanced chronic kidney disease in the elderly
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Vol. 152. Issue 5.
Pages 188-194 (March 2019)
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Vol. 152. Issue 5.
Pages 188-194 (March 2019)
Review
Shared decision-making in advanced chronic kidney disease in the elderly
Toma de decisiones compartida en la enfermedad renal crónica avanzada del anciano
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Manuel Heras Benito
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mherasb@saludcastillayleon.es

Corresponding author.
, María José Fernández-Reyes Luis
Servicio de Nefrología, Hospital General de Segovia, Segovia, Spain
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Abstract

Chronic kidney disease is common in people >65 years of age. The development and improvement of dialysis techniques has allowed its generalisation to the entire population, when there is a situation of terminal nephropathy, without limit of use due to chronological age. Decision making in elderly patients with advanced chronic kidney disease is complex: in addition to renal parameters, both comorbidity and the presence of geriatric syndromes must be considered. This review addresses the management of information, the decision making of different treatment modalities that can be offered to these patients, and the time of initiation and/or withdrawal of dialysis.

Keywords:
Advanced chronic kidney disease
Shared-decision-making
Elderly
Renal conservative treatment
Renal replacement therapy
Resumen

La enfermedad renal crónica es frecuente en personas >65 años. El desarrollo y el perfeccionamiento de técnicas de diálisis ha permitido su generalización a toda la población cuando se llega a una situación de nefropatía terminal, sin existir límite de uso por la edad cronológica. La toma de decisiones en ancianos con enfermedad renal crónica avanzada es compleja: además de parámetros renales se debe considerar la comorbilidad, así como la presencia de síndromes geriátricos. En esta revisión se aborda la gestión de la información, la toma de decisión de diferentes modalidades de tratamiento que se pueden ofertar a estos pacientes y el momento de inicio y/o retirada de diálisis.

Palabras clave:
Enfermedad renal crónica avanzada
Toma de decisiones compartida
Ancianos
Tratamiento conservador renal
Tratamiento renal sustitutivo

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