"Should I go on dialysis, Doc?": initiating dialysis in elderly patients with end-stage renal disease.

Mr K., an 83-year-old man with chronic kidney disease, coronary artery disease, mild chronic obstructive pulmonary disease, and type 2 diabetes mellitus, was recently admitted to hospital with a 2-month history of fatigue, decreased appetite, weight loss, pruritus, and dyspnea secondary to congestive heart failure not responding well to diuretics. You visit Mr K. and his family in the hospital and notice that his most recent bloodwork results show a creatinine level of 420 μmol/L, a urea level of 34 mmol/L, and creatinine clearance of 14 mL/min/1.73 m2. You see that the nephrology team has completed their consultation and has spoken to the family about dialysis.