Description
The aging population and growing epidemic of diabetes means that geriatricians will see an increasing number of patients with chronic kidney disease. It is a progressive long term condition with high mortality and morbidity, mainly due to the associated cardiovascular risk. The diagnosis should be made early, based on estimated glomerular filtration rate (eGFR), as serum creatinine alone is an insensitive measure of renal function. The main causes are diabetes, hypertension and vascular disease. Complications include bone disease, anaemia, acidosis and malnutrition. Only a minority of patients will progress to established renal failure, but it is important that these patients be adequately prepared. Treatment options include haemodialysis, peritoneal dialysis, renal transplantation and conservative care with full palliative treatment.
