Geriatric 5Ms in Patients with Kidney Disease

According to US population data, approximately 55 million residents are 65 years or older, and about a third (36.5%) have chronic kidney disease (CKD). Adults aged >65 years with CKD have the highest incident rate of end-stage kidney disease (ESKD) and, by 2030, the prevalence of ESKD is expected to increase by 23–75% for those 65–74 years old, and by 4–51% for those over 74 years old. At any given time, a nephrologist can expect to participate in the care of older adults, in collaboration with their chronic dialysis group. It is critically important that the nephrologist be familiar with the optimal care of the older adult. In this chapter, we propose that the GERIATRIC 5Ms approach might be a helpful way to organize the geriatrics issues that should be considered in patients with CKD. The tool, developed by specialists in geriatric medicine, addresses the comprehensive care of older adult in five key domains: Mind, Mobility, Medications, Multi-complexity, and Matters Most. In this chapter, we will apply the 5Ms structure to the treatment of kidney disease, as well as appraise geriatric comanagement as a model of multidisciplinary care delivery.