Figure 2.

Approach to the elderly patient with ESRD. The model uses such factors as cognitive impairment, functional impairment, and the severity of comorbid conditions to help guide the clinical thought process. The model emphasizes circumstances in which nondialytic management, including palliative care, may be appropriate, as well as the need for continual assessment of patients on dialysis to determine whether changes requiring reassessment of the appropriateness of continuing renal replacement therapy have occurred. ECD, expanded-criteria donor; HD, hemodialysis; PD, peritoneal dialysis.