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Dialysis in Late Life: Benefit or Burden

Sarbjit V. Jassal^*,, and Diane Watson^*

^* Division of Nephrology, University Health Network, Toronto, Ontario, Canada; and Department of Medicine, University of Toronto, Toronto, Ontario, Canada

Correspondence: Dr. Sarbjit V. Jassal, University of Toronto, University Health Network, 8NU-857, 200 Elizabeth Street, Toronto, M5G 2C4, Canada. Phone: 416-340-3196; Fax: 416-340-4999; E-mail: vanita.jassal{at}uhn.on.ca

As a result of the changing dialysis demographics, nephrologists are increasingly faced with problems traditionally considered to be geriatric issues. The specialty of nephrology has often been seen as using intensive, expensive, and complex technologies for patient care. Dialysis programs have evolved into highly efficient, fast-paced units that accommodate a rapid turnover of patients. They are in direct contrast to geriatric programs, which use geriatric principles to offer simple, multidimensional, holistic care to frail older patients. Finding the balance between nephrology and geriatric skill sets is a particular challenge for up-and-coming nephrologists who have an interest in geriatric nephrology. This mini-review addresses some of the challenges, increases awareness of specific issues, and highlights new opportunities in this field.