Renal Transplantation in Seniors - A Review

In the early 1980 s, nephrologists began to see a gradual rise in the number of seniors (defined as those over 65 years of age) starting renal replacement therapy (RRT). This growth was initially attributed to the increased avail­ability of dialysis, and the lifting of age-related restrictions. Over the next one or two decades the numbers of patients starting dialysis did not plateau as was expected, but rather, growth continued at fairly high rates. The most striking feature noted by epidemiologists was the difference in the rate of growth across different age bands for the initiation of dialysis. While the rate per million population (PMP) of younger patients starting dialysis stabilized, the rate of growth in the older population starting dialysis (i.e. either those in the age band 65-74yrs old or those _75 yrs) continued to rise. Although small differences were noted across the world, for example Canadian and American data showed the most dramatic increases for those 75 yrs while data from Europe, Australia and Japan showed most growth in those 60yrs of age, the trend was global.