Dr Anthony Nicholls discusses some of the issues which must be addressed when treating elderly patients with chronic renal failure

Kidney failure is a disease of elderly people. Most patients can be successfully restored to independent life but treatment may be complex and the outlook for some patients is poor. The best treatment option for many older patients is continuous ambulatory peritoneal dialysis (CAPD) since it optimises rehabilitation and independence. Heavily dependent, Socially isolated or poorly motivated older patients are best treated by hospital haemodialysis (HD) preferably in a local unit close to their homes.