Abstract
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-dialyse and dialyse care. In end stage renal failure patients with a high index comorbidity and frailty it is necessary to consider the benefit and the burden 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. Newly according to the literary sources show as an alternative solution the "dialysis for the test" and "non-aggressive nephrological care".
Comprehensive integrated care as the interconnection and the sharing of responsibility and resources is a solution for very difficult polymorbid patients. It requires the interconnection of health and social policies, which in the Czech Republic has not been resolved.