Palliation Versus Dialysis for End-Stage Renal Disease in the Oldest Old: What are the Considerations?

Lyle S. Walton, Gregory D. Shumer, Bjoerg (Bjorg) Thorsteinsdottir, Theodore Suh, Keith M. Swetz

Research output: Contribution to journalReview article

2 Scopus citations


As the US population continues to age, new cases of end-stage renal disease (ESRD) in individuals, aged 85 years or older (the oldest old), are increasing. Many patients who begin hemodialysis despite questionable benefit may struggle with high symptom burden and rapid functional decline. This article reviews the history regarding the funding and development of the Medicare ESRD program, reviews current approaches to the oldest old with ESRD, and considers strategies to improve the management approach of this vulnerable population.

Original languageEnglish (US)
JournalPalliative Care
StatePublished - Feb 17 2017



  • End-stage renal disease
  • hemodialysis
  • Medicare
  • palliative care
  • renal replacement therapy

ASJC Scopus subject areas

  • Advanced and Specialized Nursing

Cite this