What is the treatment of choice for older adults requiring maintenance dialysis?

The treatment of choice for older adults requiring maintenance dialysis is kidney transplantation. This option is often prioritized because it addresses the underlying issue of kidney failure by replacing the diseased kidneys with a healthy one from a donor. Kidney transplantation can significantly improve the quality of life for older adults, offering better long-term outcomes compared to dialysis methods. It can also enhance survival rates by reducing the complications associated with chronic dialysis treatments.

Transplantation typically allows patients to avoid the burdens of daily or multiple weekly visits for dialysis, which can be particularly taxing for older adults who may already be managing other health conditions. Furthermore, kidney transplants can lead to better physical and emotional well-being, enabling patients to resume more normal activities without the constraints of regular dialysis sessions.

In contrast, while hemodialysis and peritoneal dialysis are both effective options for maintaining kidney function, they can limit the lifestyle and increase the overall morbidity for older patients. Renal replacement therapy is a broader term that encompasses both dialysis and transplantation, but doesn't specify the preferred method for older adults, which is why kidney transplantation is the most suitable answer.