Study Identifies Reasons Underlying Dialysis Decision-Making in the Elderly.

A French prospective study of 155 octogenarians and nonagenarians who were newly referred to nephrologists by general practitioners found that nephrologists' decision to initiate dialysis was based exclusively on uremic criteria. These included uncontrolled biological abnormalities, such as hyperkalemia or acidosis (71%), uncontrolled digestive disorders (35%), uncontrolled pulmonary or peripheral edema (29%), and uncontrolled malnutrition (12%). No patients with acute congestive heart failure or cancer initiated dialysis. The BMC Nephrology study noted predictors of premature death included acute congestive heart failure, age, any walking impairment, and hemoglobin levels under 10 g/dL.