{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,24]],"date-time":"2026-02-24T00:01:03Z","timestamp":1771891263147,"version":"3.50.1"},"reference-count":53,"publisher":"Oxford University Press (OUP)","issue":"9","license":[{"start":{"date-parts":[[2025,7,4]],"date-time":"2025-07-04T00:00:00Z","timestamp":1751587200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,8,29]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n               <jats:p>The number of older people with chronic kidney disease (CKD) is increasing globally. The vast majority of these patients will die before they even have the chance to start kidney replacement therapy. Nevertheless, this clientele of older patients with CKD is often characterized not only by several concomitant diseases but also by frailty. This constellation comes with a general vulnerability and very heterogeneous courses of disease that need to be considered when it comes to diagnosis and treatment. The main difference compared with younger patients is that therapy and therapy decisions are often preceded by the need for assessments. These can relate to frailty, but also to closely related areas such as cognition, depression or malnutrition among others. The basic therapeutic approaches for CKD treatment in a geriatric patient may not differ fundamentally though from those for younger patients. This also holds true for standard as well as more novel medication administered for nephroprotection. The difference however, lies in the fact that personalized approaches are more frequently required due to survival probability, a more complex mix of chronic conditions, and individual patient's needs and aims. This also applies to the difficult decision as to whether a very old person with CKD G5 should be dialyzed or treated conservatively. Information from different areas should be incorporated into a joint decision-making process, which often requires intensive, patient-centered communication about the patient's preferences and prioritized treatment goals, psychosocial factors and their home environment, as well as their medical needs and prognosis.<\/jats:p>","DOI":"10.1093\/ndt\/gfaf115","type":"journal-article","created":{"date-parts":[[2025,7,3]],"date-time":"2025-07-03T07:57:11Z","timestamp":1751529431000},"page":"1672-1679","source":"Crossref","is-referenced-by-count":3,"title":["Treatment standard: CKD in the geriatric patient"],"prefix":"10.1093","volume":"40","author":[{"given":"Elke","family":"Schaeffner","sequence":"first","affiliation":[{"name":"Charit\u00e9 Universit\u00e4tsmedizin Berlin Institute of Public Health, , Berlin ,","place":["Germany"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Markus","family":"Ketteler","sequence":"additional","affiliation":[{"name":"Robert-Bosch-Hospital Department of General Internal Medicine and Nephrology, , Stuttgart ,","place":["Germany"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2025,7,4]]},"reference":[{"key":"2025082900415174300_bib1","doi-asserted-by":"crossref","first-page":"S117","DOI":"10.1016\/j.kint.2023.10.018","article-title":"KDIGO 2024 clinical practice guideline for the evaluation and management of chronic kidney disease","volume":"105","author":"Kidney Disease: Improving Global Outcomes (KDIGO) CKD Work Group","year":"2024","journal-title":"Kidney Int"},{"key":"2025082900415174300_bib2","doi-asserted-by":"publisher","first-page":"F938","DOI":"10.1152\/ajprenal.00256.2017","article-title":"Inflammation and premature aging in advanced chronic kidney disease","volume":"313","author":"Kooman","year":"2017","journal-title":"Am J Physiol Renal Physiol"},{"key":"2025082900415174300_bib3","doi-asserted-by":"publisher","first-page":"afad063","DOI":"10.1093\/ageing\/afad063","article-title":"Association of kidney function and albuminuria with frailty worsening and death in very old adults","volume":"52","author":"Mielke","year":"2023","journal-title":"Age Ageing"},{"key":"2025082900415174300_bib4","doi-asserted-by":"publisher","first-page":"e087189","DOI":"10.1136\/bmjopen-2024-087189","article-title":"Longitudinal frailty assessment in the prediction of survival among patients with advanced chronic kidney disease: a prospective observational single-centre cohort study","volume":"14","author":"Kennard","year":"2024","journal-title":"BMJ Open"},{"key":"2025082900415174300_bib5","doi-asserted-by":"publisher","first-page":"258","DOI":"10.1186\/s12882-023-03303-1","article-title":"Prevalence of physical frailty and impact on survival in patients with chronic kidney disease: a systematic review and meta-analysis","volume":"24","author":"Zhang","year":"2023","journal-title":"BMC Nephrol"},{"key":"2025082900415174300_bib6","doi-asserted-by":"publisher","first-page":"236","DOI":"10.1093\/ckj\/sfx134","article-title":"Frailty and chronic kidney disease: current evidence and continuing uncertainties","volume":"11","author":"Nixon","year":"2018","journal-title":"Clin Kidney J"},{"key":"2025082900415174300_bib7","doi-asserted-by":"publisher","first-page":"M146","DOI":"10.1093\/gerona\/56.3.M146","article-title":"Frailty in older adults: evidence for a phenotype","volume":"56","author":"Fried","year":"2001","journal-title":"J Gerontol A Biol Sci Med Sci"},{"key":"2025082900415174300_bib8","doi-asserted-by":"publisher","first-page":"489","DOI":"10.1503\/cmaj.050051","article-title":"A global clinical measure of fitness and frailty in elderly people","volume":"173","author":"Rockwood","year":"2005","journal-title":"CMAJ"},{"key":"2025082900415174300_bib9","doi-asserted-by":"publisher","first-page":"187","DOI":"10.1186\/s13643-022-02052-w","article-title":"Systematic review of the utility of the frailty index and frailty phenotype to predict all-cause mortality in older people","volume":"11","author":"Kim","year":"2022","journal-title":"Syst Rev"},{"key":"2025082900415174300_bib10","doi-asserted-by":"publisher","first-page":"279","DOI":"10.1007\/s41999-021-00570-9","article-title":"Frail by different measures: a comparison of 8-year mortality in The Irish Longitudinal Study on Ageing (TILDA)","volume":"13","author":"Romero-Ortuno","year":"2022","journal-title":"Eur Geriatr Med"},{"key":"2025082900415174300_bib11","doi-asserted-by":"publisher","first-page":"2463565","DOI":"10.1080\/0886022X.2025.2463565","article-title":"Kidney function and cognitive impairment: a systematic review and meta-analysis","volume":"47","author":"Pei","year":"2025","journal-title":"Ren Fail"},{"key":"2025082900415174300_bib12","doi-asserted-by":"publisher","first-page":"189","DOI":"10.1016\/0022-3956(75)90026-6","article-title":"\u201cMini-mental state\u201d. 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