Drugs in the elderly with chronic kidney disease: beware of potentially inappropriate medications

In this issue of NDT, Kondo et al. [1] address a clinically rele-vant topic, which has been rarely studied so far in the chronic kidney disease (CKD) population: the use of potentially in-appropriate medications (PIMs). In particular, they studied the frail subset of elderly haemodialysis subjects, who are more exposed to the potentially severe adverse effects of medication errors, especially when multiple therapies are prescribed. The study of Kondo refers to 1367 elderly patients with a median age of 72 years and a range of 65–98 years [1], reflect-ing the European prevalent dialysis population, including many old or very old patients. Elderly people are at higher risk of side effects even for a single drug for many pharmacokinetic reasons. A healthy 40-year-old subject has a total body water content of 55 % of body weight (women) or 60 % (men), progressively declining t