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BACKGROUND Health-related quality of life (QOL) is an important outcome for older people who are often on dialysis for life. Little is, however, known about differences in QOL on haemodialysis (HD) and peritoneal dialysis (PD) in older age groups. Randomising patients to either modality to assess outcomes is not feasible. METHODS In this cross-sectional,(More)
BACKGROUND Elderly patients with end-stage renal disease and severe extra-renal comorbidity have a poor prognosis on renal replacement therapy (RRT) and may opt to be managed conservatively (CM). Information on the survival of patients on this mode of therapy is limited. METHODS We studied survival in a large cohort of CM patients in comparison to(More)
OBJECTIVES To study factors influencing the recommendation for palliative (non-dialytic) treatment in patients approaching end-stage renal failure and to study the subsequent outcome in patients choosing not to dialyse. DESIGN Cohort study of patients approaching end-stage renal failure who underwent multidisciplinary assessment and counselling about(More)
Depression is the most common psychopathological condition among patients with end-stage renal disease (ESRD), yet it is still under-recognized and misdiagnosed. Depression reduces quality of life and has a negative clinical impact upon sufferers with chronic illness, including ESRD. This article discusses the negative effects of depression among the ESRD(More)
PURPOSE OF REVIEW Elderly patients comprise the fastest growing population initiating dialysis and also experience the worst outcomes, including increased mortality, loss of functional status, and impaired quality of life. Nephrologists are often challenged with how best to engage in dialysis decision-making discussions within this population.(More)
Treatment with dialysis has benefitted large numbers of patients with advanced kidney disease. It is though highly intrusive and demanding and some elderly, frail patients may tolerate it poorly. Some of these patients who are either approaching 'end-stage' kidney disease or 'failing' despite being on dialysis may choose to pursue supportive or palliative(More)
BACKGROUND AND OBJECTIVES Depression is common in patients on hemodialysis, but data on the benefits and risks of antidepressants in this setting are limited. We conducted a multicenter, randomized, double-blind, placebo-controlled trial of sertraline over 6 months in patients on hemodialysis with depression to determine study feasibility, safety, and(More)
The EDTNA/ERCA survey of the provision of pre-ESRF information, education and counselling in renal care was the third project organised through the Collaborative Research Programme (CRP). Data was collected from 35 participating centres in 10 countries. The majority of participating centres had a structured pre-ESRF programme. Advice and education received(More)
BACKGROUND AND OBJECTIVES Benefits of dialysis in elderly dependent patients are not clearcut. Some patients forego dialysis, opting for conservative kidney management (CKM). This study prospectively compared quality of life and survival in CKM patients and those opting for dialysis. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS Quality-of-life(More)
BACKGROUND Not all patients are suitable for kidney transplantation; however, little is known about the views and attitudes of patients who are not on the waiting list for transplantation. OBJECTIVE This study aimed to determine the views and attitudes of patients who are not on the waiting list regarding the process of transplant allocation. METHODS A(More)