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Q J Med 2000; 93: 253-255
© 2000 Association of Physicians

Commentary

Rationing renal replacement therapy to older patients–agreed guidelines are needed

E.C. Mulkerrin

From the Department of Medicine for the Elderly, University College Hospital, Galway, Ireland


   Introduction
 
It has been predicted that the requirement for renal replacement therapy in the U.K. will increase by 50–100% within 15 years.1 This therapy is an expensive resource2 and unlimited access to treatment will prove difficult to fund. The number of persons aged >65 years is increasing in all developed countries, and this trend is projected to continue into the future.3 There is a steep rise in the incidence of end-stage renal failure with age,4,5 and much of the aforementioned rise in the requirement for renal replacement therapy relates to these demographic changes. Increased acceptance of older patients for replacement therapy in the UK is evidenced by a rise in the proportion of older persons (>65 years) from 11% to 41% between 1982 and 1995.6

Nonetheless, a huge disparity in overall acceptance rates persists between the UK, Canada and the . . . [Full Text of this Article]


   Acknowledgments
 

   References
 

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