About Our Services for Older Adults with Kidney Disease

Mount Sinai strives to meet the specific needs of older adults with advanced kidney disease by providing comprehensive care personalized to each patient. As people age, particularly those older than 80 years, more medical and geriatric conditions tend to accumulate and can affect daily life. Having to face the possibility of dialysis can be a big challenge for many people, and an even greater one for older adults.

In an effort to address this, Mount Sinai offers dialysis as a treatment option, as well a unique, alternative approach called of non-dialysis medical therapy. Since chronic kidney disease is a progressive illness, both of these treatment options offered at Mount Sinai integrate the concepts of palliative care, a specialized medical approach that focuses on relieving the symptoms, pain, and stress of a serious illness—whatever the diagnosis or life expectancy. Non-dialysis medical therapy is appropriate at any age and at any stage of a serious illness, and can be provided together with life-sustaining treatments including dialysis.

With a focus on shared decision-making between doctor, patient, and their loved ones, our physicians are skilled in matching the right kidney treatment plan to the needs and goals of our older adult renal patients and their families. Our goal is to maximize quality of life while preserving integrity and personal independence alongside excellent medical care.

Tailoring Kidney Treatments to Older Patients

In providing expert, compassionate care, our Nephrology Division brings a crucial geriatric perspective to the care of kidney patients over the age of 60, who may have varying degrees of frailty, memory and functional impairments, and psychological and family issues. This blend of renal and geriatric specialties helps patients and their families to better understand and manage the progression of chronic kidney disease. Mount Sinai is working to formalize this integrated approach to care through a new fellowship program that trains nephrologists to also become board-certified in either geriatrics or palliative care. As one of the world's leading hospitals and a highly ranked medical school, we are able to provide access to experts across multiple specialties, from cardiology to urology.

Offering Dialysis and Non-Dialysis Therapies in the Elderly

While dialysis is the more conventional therapy for older patients with advanced kidney disease (the fastest growing segment of the dialysis population is over the age of 75), it is by no means the only one. Today Mount Sinai is at the forefront of implementing the emerging practice of non-dialysis medical therapy which uses both a targeted and holistic approach to treat advanced kidney disease in the elderly. It intensively manages kidney failure by using medications to treat the various aspects of renal disease, which include anemia, acidosis (excess acid in body fluids), and fluid overload (excess fluid in the body). Employing the principles of palliative care, we also actively treat burdensome symptoms, implement advanced care planning, help with transitions of care as new events occur and patient status changes, and provide support for family members.

Whether served on an inpatient or an outpatient basis, older adults with kidney disease coming to Mount Sinai have access to the best of nephrology, geriatrics, and palliative care. Our goal is to partner with our patients and their families to achieve the best possible quality of life.