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ARTICLE |

Dialysis, Old Age, and Rehabilitation FREE

Christopher R. Blagg, MD; Sally S. Fitts, PhD
[+] Author Affiliations

Reprint requests to the Northwest Kidney Centers, 700 Broadway, Seattle, WA 98122 (Dr Blagg).


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."

REFERENCES

Byrne C, Vernon P, Cohen JJ.  Effect of age and diagnosis on survival of older patients beginning chronic dialysis. JAMA . 1994;;271:34-36.
Ifudu O, Mayers J, Matthew J, Tan CC, Cambridge A, Friedman EA.  Dismal rehabilitation in geriatric inner-city hemodialysis patients. JAMA . 1994;;271:29-33.
Westlie L, Umen A, Nestrud S, Kjellstrand CM.  Mortality, morbidity, and life satisfaction in the very old dialysis patient. Trans Am Soc Artif Intern Organs . 1984;;30:21-30.
Stewart AL, Ware JE. Measuring Functioning and Well-Being . Durham, NC: Duke University Press; 1992;.
Evans RW, Manninen DL, Garrison LP, et al.  The quality of life of patients with end-stage renal disease. N Engl J Med . 1985;;312:553-559.
Quevedo S.  Quality of life in patients with end-stage renal disease: a clinician's view. Am Kidney Found Nephrol Lett . 1991;;8:13-20.
Kutner N, Brogan DJ.  Assisted survival, aging, and rehabilitation needs: comparison of older dialysis patients and age-matched peers. Arch Phys Med Rehabil . 1992;;73:309-315.
Kutner NG, Cardenas DD, Bower JD.  Rehabilitation, aging, and chronic renal disease. Am J Phys Med Rehabil . 1992;;71:97-101.
Buchner DA, Wagner EH.  Preventing frail health. Clin Geriatr Med . 1992;;8:1-17.
Stewart DA, Burns JMA, Dunn SG, Roberts MA.  The 2-minute walking test: a sensitive index of mobility in the rehabilitation of elderly patients. Clin Rehabil . 1990;;4:273-276.
US Renal Data System. USRDS1993 Annual Data Report . Bethesda, Md: National Institutes of Health, National Institute of Diabetes and Digestive and Kidney Diseases; March 1993;:H.1.

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Byrne C, Vernon P, Cohen JJ.  Effect of age and diagnosis on survival of older patients beginning chronic dialysis. JAMA . 1994;;271:34-36.
Ifudu O, Mayers J, Matthew J, Tan CC, Cambridge A, Friedman EA.  Dismal rehabilitation in geriatric inner-city hemodialysis patients. JAMA . 1994;;271:29-33.
Westlie L, Umen A, Nestrud S, Kjellstrand CM.  Mortality, morbidity, and life satisfaction in the very old dialysis patient. Trans Am Soc Artif Intern Organs . 1984;;30:21-30.
Stewart AL, Ware JE. Measuring Functioning and Well-Being . Durham, NC: Duke University Press; 1992;.
Evans RW, Manninen DL, Garrison LP, et al.  The quality of life of patients with end-stage renal disease. N Engl J Med . 1985;;312:553-559.
Quevedo S.  Quality of life in patients with end-stage renal disease: a clinician's view. Am Kidney Found Nephrol Lett . 1991;;8:13-20.
Kutner N, Brogan DJ.  Assisted survival, aging, and rehabilitation needs: comparison of older dialysis patients and age-matched peers. Arch Phys Med Rehabil . 1992;;73:309-315.
Kutner NG, Cardenas DD, Bower JD.  Rehabilitation, aging, and chronic renal disease. Am J Phys Med Rehabil . 1992;;71:97-101.
Buchner DA, Wagner EH.  Preventing frail health. Clin Geriatr Med . 1992;;8:1-17.
Stewart DA, Burns JMA, Dunn SG, Roberts MA.  The 2-minute walking test: a sensitive index of mobility in the rehabilitation of elderly patients. Clin Rehabil . 1990;;4:273-276.
US Renal Data System. USRDS1993 Annual Data Report . Bethesda, Md: National Institutes of Health, National Institute of Diabetes and Digestive and Kidney Diseases; March 1993;:H.1.
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