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[Optimal care for chronic renal failure in the elderly].

Incidence and prevalence of chronic kidney disease in the elderly are growing steadily in developed countries. Progression to end-stage renal failure in this age class is currently a major public health problem. Elderly subjects with chronic renal failure (CRF) are referred to nephrology units too late, leading to less than optimal medical care. Efforts should be made to: 1. identify kidney disease early; 2. slow down progression of CRF; 3. prevent or treat CRF complications i.e. hypertension, anemia, phosphocalcic disorders, acidosis; 4. control comorbidities, particularly cardiovascular disease; and 5. inform patients and families about renal replacement therapies (RRT) and prepare patients if RRT is indicated. The main objectives are retarding or avoiding RRT, decreasing morbid-mortality, and maintaining good quality of life.