The older patient population on dialysis in the UK and in our renal units is increasing with the need for more supportive care related to old age and frailty. Frailty and its associated syndromes were shown to be more common in patients with chronic kidney disease and those on dialysis than in older people without renal impairment. This can result in adverse outcomes such as falls, disability, hospitalisation and mortality.

In frail older patients admitted to hospital geriatric assessments and post discharge home interventions have shown to reduce hospital stay and readmissions, the need for immediate nursing home placements and delay permanent placement. Similar outcomes should be possible if applied in the case of renal patients. As such, the Renal Geriatric Integration Project was set up to address this area of need and to reduce the risk of adverse outcomes for frail older dialysis patients.

The increasing supportive care needs of the elderly and often frail dialysis patients put extra demands on renal unit nursing teams. While the majority of staff were involved in organising support for patients some felt that that they did not have adequate time to deal with the increasing patients’ needs (64% in HD unit and 40% in PD unit).

In our experience older renal patients do not often contact their primary care teams in the community and rely on nursing staff in the dialysis units to help deal with their issues, while GPs sometimes defer care to the dialysis teams. To find out more click on the below link.

Renal Geriatric Integration Project – Imperial College Health Care NHS Trust