 The proportion of elderly patients with end-stage kidney disease undergoing renal replacement therapy RRT is steadily increasing. National registry data consistently shows a trend towards increasing median ages for patients both starting dialysis and awaiting kidney transplantation on deceased-donor waiting lists For example, in the United Kingdom, national audit data from the UK Renal Registry demonstrates that the median age for all incident patients commencing RRT was 64.5 years Among the prevalent RRT population, the percentage of patients aged greater than 70 years has increased from 19.2 in 2000 to 25.0 in 2013 in the last registry report Focusing on data from the UK Transplant Registry, 28 of transplant recipients receiving a deceased-donor kidney allograft in the last year were aged 60 and over 7 were aged 70 and over, while 32 of the active kidney transplant waiting list is aged 60 and over 9 aged 70 and over With chronic kidney disease increasingly recognized as a public health epidemic, the long-term prospects are of an increasingly elderly component to our end-stage kidney disease population. 