The Elderly Patient with End-Stage Renal Disease: Is Dialysis the Best and Only Option?

Singapore is facing an ageing population. This is reflected in the growing number of patients needing to consider starting dialysis in their golden years. In our review, we have found that there is a survival benefit for starting dialysis in our geriatric end-stage renal disease (ESRD) patient with low comorbidity. However, this comes at an expense of reduced quality of life, increased hospitalisation and reduced functional status. The decision to start or withhold dialysis in an elderly patient is a complex one and has to be considered on an individual basis with continuous discussions with the patient and loved ones. Advance Care Planning is a useful tool that can assist in this process.