Journal Article

Prolonged conservative treatment for frail elderly patients with end-stage renal disease: the Verona experience

Vincenzo De Biase, Olga Tobaldini, Claudia Boaretti, Cataldo Abaterusso, Nicoletta Pertica, Carmelo Loschiavo, Gaetano Trabucco, Antonio Lupo and Giovanni Gambaro

in Nephrology Dialysis Transplantation

Published on behalf of European Renal Association - European Dialysis and Transplant Assoc

Volume 23, issue 4, pages 1313-1317
Published in print April 2008 | ISSN: 0931-0509
Published online November 2007 | e-ISSN: 1460-2385 | DOI: http://dx.doi.org/10.1093/ndt/gfm772
Prolonged conservative treatment for frail elderly patients with end-stage renal disease: the Verona experience

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Background. In frail elderly patients, the chronic use of renal replacement therapy sometimes affords no tangible benefits and may even negatively affect their quality of life (Qol), making prolonged conservative management a reasonable option.

Methods. This observational, uncontrolled study was conducted on 11 end-stage renal disease patients over 75 years of age, on prolonged conservative treatment with a follow-up of at least 6 months, to assess compliance with the Italian clinical guidelines concerning the treatment of renal failure, comorbidities, hospital stays, and several psychometric and Qol indicators in the patients and their caregivers.

Results. We found a substantial compliance with the targets recommended in the guidelines, a moderate tendency for disease progression and satisfactory psychometric and Qol parameters, which proved much the same as those observed in a parallel (uncontrolled) group of patients on haemodialysis.

Conclusions. Our study shows that a conservative strategy is feasible for frail uraemic patients, achieving acceptable clinical results and a Qol comparable with patients on haemodialysis. The study also provides indications on how to plan trials on this topic, to obtain the evidence needed to guide the difficult choice of whether to recommend dialysis or conservative treatment for such frail patients.

Keywords: caregiver; conservative treatment; dialysis; frail; quality of life

Journal Article.  3178 words. 

Subjects: Nephrology

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