Kidney disease in older people — RSM symposium proceedings

Lay summary

Older people are the fastest-growing group living with chronic kidney disease (CKD), and the diagnostic and treatment decisions facing them are often more complex than for younger patients. Many of the standard tools clinicians use to assess kidney function were developed in mixed-age populations and can mislead in old age; comorbidities, polypharmacy, and frailty change the calculation for treatments such as dialysis, transplant assessment, and conservative management. Yet geriatric medicine and nephrology are organised as separate specialties with separate training, and clinicians on both sides often see the same older patient through different lenses.

In January 2017 the Royal Society of Medicine Geriatrics and Gerontology Section ran a national symposium on "Kidney Disease in Older People" — chaired by Dr Wright — bringing together geriatricians, nephrologists, and researchers to look at the interface. The proceedings paper, published open-access in Gerontology and Geriatric Medicine later that year, summarises the discussion and the practical recommendations that came out of it. Dr Wright is the second author.

The paper is intended as a reference for clinicians working with older patients who have CKD or are being considered for dialysis, and as a starting point for further joint geriatric–nephrology training.