Chronic kidney disease and its treatment in the elderly: an integrative review

AbstractPopulation aging, along with the increasing incidence of chronic diseases, has contributed to a global rise in the prevalence of chronic kidney disease (CKD). The aim of this study was to perform an integrative review of proposed treatments for elderly patients with non-dialysis phase CKD. A literature search was performed of studies written from January 2002 to May 2013, registered on the MEDLINE, LILACS, SciELO and Science Direct electronic databases, using the keywords: chronic kidney disease, treatment and elderly. Complete, freely available articles were included. Initially, 215 items were identified. After the eligibility phase, 13 articles were included in this integrative review. The therapeutic interventions recommended for the management of CKD include the control of hypertension, diabetes and dyslipidemia, changes to diet, weight reduction and abstinence from smoking. In terms of treatment, for many older people with CKD, an individualized patient-centered approach may be more effective than the traditional disease-oriented strategy. Referral to a nephrologist appears to be a beneficial procedure for the management of renal disease. While there was an apparent effort by researchers to institute more effective therapeutic approaches, there was little evidence of interventions that might improve survival rates of elderly patients with CKD. However, some interventions prevent exacerbation of the disease, and delay the progression of CKD. There is therefore a need to conduct long-term randomized controlled trials of elderly patients with CKD in order to identify the most effective therapeutic procedures for the control of this disease.