Management of Conservative and Palliative Care in CKD

There are several different treatment modalities available to people who progress to advanced kidney disease. The main types of treatment are renal replacement therapies (RRT), including peritoneal dialysis, hemodialysis (HD), and kidney transplantation. Significant advances in the treatment and management of kidney disease mean that older people, and those with high levels of comorbidity, are being successfully treated with RRT. While kidney transplantation is the gold standard RRT, this option frequently is not available for older people due to their levels of frailty, comorbidity, and risk of undergoing an invasive surgery. Therefore, the most common RRT for older people who reach kidney failure is HD [1]. In general, the HD population is getting older as the overall population ages, meaning that the average age for people who start HD is 66.8 years old [2].