Care of the older person with kidney failure.

Dialysis and renal transplants have become a reality in the XXIst century. Their use in third world countries has profound impacts on social, economic, political and cultural aspects. Extraordinary achievements for the medical world, that is constantly concerned in improving the health levels for the population; but what are the repercussions for the lower income groups? Is the cost/benefit relationship being analysed? Is there ample information available and is it well distributed regarding how to avoid the need for dialysis or a kidney transplant? What recommendations are made to the health care workers? And, what has been revealed to us after reflecting on the philosophical/historical aspects of the human existence? How valuable are Dr. Ivan Illich's observations and what can we expect from health care workers in relation to such significant achievements as we face the XXIst century?