Ethical issues in aging and renal disease

The incidence of elderly patients reaching end-stage renal disease (ESRD) a nd requiring renalreplacement is increasing. Better medical care is helping patients live longer but, at the same time, is raising ethical questions. Treatment decisions for ESRD patients present a forum for the consideration of ethical questions surrounding the issues of scarce health care resource allocation and the withholding or withdrawal of life-sustaining treatment. As background for the consideration of ethical issues in ESRD patients, th e quality of life they experience and what they may expect as death approac hes also are discussed. (C) 2000 by the National Kidney Foundation, Inc.