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<p>The demographic change is leading to an increasing number of older people with chronic kidney disease (CKD). Multimorbidity, geriatric syndromes and the heterogeneity of the ageing process all contribute to a&#xa0;“new complexity” of treatment, which needs to include more person-specific considerations. Geriatric instruments can help to assess resources, limitations, prognosis and support shared decision-making and can form the basis of targeted interventions to improve the quality of life, functionality and the preservation of autonomy. The treatment should be tailored to the patient’s goals and priorities. In this article we propose an algorithm for the screening and modified geriatric assessment of older people with CKD, which enables an individualized assessment of prognosis and can serve as a&#xa0;basis for further investigations and interventions. A&#xa0;coordinated interdisciplinary care is necessary to meet the complex needs of these patients. This requires closer cooperation of nephrologists with geriatrics, palliative medicine and nursing/therapeutic areas, among others. New structures such as outpatient geriatric centers and interdisciplinary level&#xa0;1i hospitals could optimize care in the future.</p>

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Nephrologie 2030: Kann Versorgungssicherheit gelingen?

  • 期刊论文

  • 发表日期：

    2025年4月4日

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  • Lena Schulte-Kemna,
  • Michael Denkinger,
  • Paul Brinkkötter

摘要

The demographic change is leading to an increasing number of older people with chronic kidney disease (CKD). Multimorbidity, geriatric syndromes and the heterogeneity of the ageing process all contribute to a “new complexity” of treatment, which needs to include more person-specific considerations. Geriatric instruments can help to assess resources, limitations, prognosis and support shared decision-making and can form the basis of targeted interventions to improve the quality of life, functionality and the preservation of autonomy. The treatment should be tailored to the patient’s goals and priorities. In this article we propose an algorithm for the screening and modified geriatric assessment of older people with CKD, which enables an individualized assessment of prognosis and can serve as a basis for further investigations and interventions. A coordinated interdisciplinary care is necessary to meet the complex needs of these patients. This requires closer cooperation of nephrologists with geriatrics, palliative medicine and nursing/therapeutic areas, among others. New structures such as outpatient geriatric centers and interdisciplinary level 1i hospitals could optimize care in the future.