Abstract
A conglomeration of adverse factors, primarily the additive effect of the chronological and pathological aging along with polymorbidity increases the prevalence of patients with frailty phenotype in pre-dialysis and dialysis care. In end stage renal failure patients with a high index of comorbidity and frailty it is necessary to consider the benefits and the burdens of renal replacement therapy and to individualize the approach to patients with regard to the social and legislative aspects of the problem.
Assisted peritoneal dialysis could be the solution for polymorbid frailty patients with a short life prognosis. New findings, according to the literature, show a viable alternative solution in form of "dialysis for the test" and "non-aggressive nephrological care".
Comprehensive integrated care and sharing of responsibility and resources is a solution for very difficult polymorbid patients. It requires interconnectedness of health and social policies, which is an issue which has not yet been resolved in the Czech Republic.