Renal Failure, Dialysis, and Transplantation in Older Adults
The application of comorbidity scales and the determination of performance status will assist in the assignment of treatment options for end-stage renal disease patients. Age matching of donors and recipients for deceased donor kidney transplantation will balance equity and justice. Recipient surgery is determined by vascular and urinary tract anatomy and function. Immunosuppression is tailored to immunologic competence. Management of post-transplant urologic problems is straightforward. Elderly people should not be automatically disqualified as renal donors.
KeywordsCalcineurin Inhibitor Mycophenolate Mofetil Delay Graft Function Ureteral Obstruction Benign Prostatic Obstruction
Thank you to Megan Taylor, Administrative Coordinator for the Department of Urology, for 30 years of helping me write articles and book chapters and for helping me meet publication deadlines.
- 1.U.S. Renal Data System, USRDS. Annual data report: atlas of chronic kidney diseases and end-stage renal disease in the United States. Bethesda, MD: National Institutes of Health, National Institute of Diabetes and Digestive and Kidney Diseases; 2010.Google Scholar
- 6.Clinical practice guideline on shared decision-making in the appropriate initiation and withdrawal from dialysis. http://www.aacn.org/WD/Practice/Docs/CP_Guideline. Accessed 11 Sept 2011.
- 8.Karnofsky DA, Burcherval JH. The clinical evaluation of chemotherapeutic agents in cancer. In: MacLeod CM, editor. Evaluation of chemotherapeutic agents in cancer. New York, NY: Columbia University Press; 1949. p. 191–205.Google Scholar
- 9.Estimated prognosis for dialysis patients. http://www.nephron.org/cgi-bin/rpa_sdm.cgi. Accessed 9 Jan 2012.
- 13.Recommended immunizations schedules for children, teens, and adults. http://www.immunize.org/catg.d/p2011.pdf. Accessed 3 Jan 2012.
- 22.Tullis SG, Tran H, Guleria I, et al. The combination of donor and recipient age is critical in determining host immunoresponsiveness and renal transplant outcome. Ann Surg. 2010;252:662–74.Google Scholar
- 27.Zowanda ET. The aging kidney. In: Massry SG, Glassock RJ, editors. Textbook of nephrology. 2nd ed. Baltimore, MD: Williams and Wilkins; 1990. p. 996.Google Scholar