[Renal replacement therapy in the elderly patients in the Gdansk Pomeranian region].

Aging of population is a common phenomenon all over the civilized world. It results in increasing number of aged patients with end-stage renal disease. We analysed patients over 65 years who have been qualified for renal replacement therapy (RRT) since 1997. From that time age was no longer barrier for RRT in Pomerania region. Number of aged patients starting RRT raised systematically and achieved 61 pts in 2000. It was 25% of all starting this therapy in our region. In this period we observed changes in the causes of primary renal diseases: diabetic nephropathy raised from 15 to 27.8%, but hypertensive nephropathy unexpectedly was stable at 5%. Most of elderly patients qualified for RRT lived in town--74.6%. It means that many of them living in rural areas did not have adequate nephrological care and probably some of them have not been qualified for RRT. Late referral in this group is still a great problem. Many patients have never been referred to nephrologist before starting RRT. In majority of those cases no definitive diagnosis of ESRD was established. At present we are aiming at international standards and patients are started on RRT with lower level of serum creatinine than earlier. Increasing number of patients with diabetic nephropathy and in advanced age will require great effort both from nephrological community and health care system.