Table 5.

Specific issues to address in informed consent discussions with older CKD patients

Dialysis may not confer a survival advantage over maximum medical management.
Patients with their level of illness are more likely to die than live long enough to progress to ESRD.
Life on dialysis entails significant burdens that may detract from their quality of life.
It is likely that they may not experience any functional improvement with dialysis.
They may undergo significant functional decline during the first year after dialysis initiation.
Maximum medical management includes usual integrated CKD care.
Palliative care is available irrespective of their decision to pursue or forego dialysis.
Hospice is an appropriate consideration for patients with additional terminal illness.