New Guideline on Management of Older Patients with CKD

(November 2, 2016) - In the industrialized world, the average age of dialysis patients is constantly rising. People have now a significantly higher life expectancy than 50 years ago, and chronic kidney disease (CKD) is a disease that often occurs in older age. The CKD and dialysis populations are aging, thus posing new challenges for nephrology. Older patients have more comorbidities, a different physiology and, of course, a shorter life expectancy. The latter aspect, especially, may impact therapeutic decisions, for example whether renal replacement therapy should be initiated or conservative treatment be maintained.

To face the challenges posed by this growing subgroup of CKD patients, the European Renal Best Practice Group has now published the "Clinical Practice Guideline on management of older patients with chronic kidney disease stage 3b or higher (eGFR<45ml/min/1.73m2)".

"The Guideline intends to provide an evidence-based rationale and, thus, to facilitate informed decision-making on the management of older patients with CKD", explains Prof. Wim Van Biesen, the European Renal Best Practice chairman. "But old is not always old, meaning that chronological age and biological age may differ substantially. The Guideline therefore recommends that frailty scores and life expectancy be taken into account. The logic of the Guideline is to deliver a kind of risk stratification that helps to determine the best clinical management for each individual patient."


With more than 7,000 members, the ERA-EDTA ("European Renal Association – European Dialysis and Transplant Association") is one of the biggest nephrology associations worldwide and one of the most important and prestigious European Medical Associations. It supports basic and clinical research in the fields of clinical nephrology, dialysis, renal transplantation and related subjects. The ERA-EDTA supports a number of studies as well as research groups and has founded a special "Fellowship Programme" for young investigators as well as grant programmes. In order to involve young nephrologists in all activities of the ERA-EDTA the Council decided to create a Young Nephrologists’ Platform (YNP). Besides, it has established various research networks and different working groups to promote the collaboration of nephrologists with other medical disciplines (e.g. cardiology, immunology). Furthermore, a "European Renal Best Practice" (ERBP) advisory board has been established by the ERA-EDTA to draw up and publish guidelines and position statements. Another important goal of the ERA-EDTA is education: several series of CME-courses as well as the annual congress offer an attractive scientific programme to cover the need of continuous medical education for doctors working in the fields of nephrology, dialysis and transplantation. The association’s journals, NDT (Nephrology, Dialysis, Transplantation) and ckj (Clinical Kidney Journal), are currently the leading nephrology journals in Europe. The ERA-EDTA Registry is a large epidemiologic database comparing countries by assessing nephrology practice throughout Europe. Finally, ERA-EDTA is member of the European Kidney Health Alliance (EKHA), a consortium of renal societies that actively interacts with the European Parliament.

ERA-EDTA - "European Renal Association – European Dialy sis and Transplant Association", 02.11.2016 .