End-stage renal disease and its management in older adults.

The older patient with renal disease presents the nephrologist with a formidable problem list: treatment of end-stage renal disease (ESRD) in these patients can be viewed as a continuum in the management of several diseases at one time. The older ESRD patient with complex medical problems is a challenge to the health care team, clearly requiring the cooperation of physician, nurse, dialysis technician, social worker, dietician, physical medicine specialist, and a host of other subspecialists. The outcomes, however, are gratifying, in that a satisfactory and enjoyable autumn of life is attainable for many.