Special Considerations in the Management of Chronic Kidney Disease in the Elderly

The care of elderly people with CKD may be complicated by several factors, including uncertainty about the accuracy and signifi cance of low GFR estimates, age-associated pharmacokinetic changes and the high prevalence of polypharmacy, and co-morbid conditions. All of these factors make weighing the risks and benefi ts of CKD treatment strategies more challenging. In the management of elderly patients, it is important to keep in mind that CKD clinical practice guidelines, such as those for blood pressure control, were largely developed in nonelderly populations with CKD. Thus, CKD treatment guidelines must be tailored to suit the individual patient and his or her treatment goals and preferences. Ultimately, achieving patient-centered care for the growing elderly population with CKD will require a more collaborative approach with pharmacists and geriatricians and individualized care plans that go beyond the guidelines.