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Dialysis, Old Age, and Rehabilitation

Christopher R. Blagg, MD; Sally S. Fitts, PhD
JAMA. 1994;271(1):67-68. doi:10.1001/jama.1994.03510250083041.
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Health care reform and an aging population have rekindled concerns about treatment of the elderly by high-cost technology, so it is timely that two articles in this issue of The JOURNAL discuss elderly dialysis patients. Byrne et al1 report survival with chronic dialysis in the elderly and the relatively poor life expectancy compared with age-matched peers in the general population, especially when end-stage renal disease (ESRD) is caused by diabetes. Ifudu et al2 describe "dismal" rehabilitation in elderly inner-city hemodialysis patients; again, diabetics fared less well than nondiabetics. Despite the authors' disclaimers, both articles may well be used by "those who wish to institute age-based rationing of hemodialysis."

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