The master tool of logic is the syllogism. If A> Band B> C, then it must follow as the night the day that A > C. If the major and minor premises are true or scientifically correct by current knowledge, the conclusion is true or at least scientifically correct by current knowledge. The demographer of today beams a clear message, which if not true is at least scientifically correct by current knowledge. In the first 80 years of the Twentieth Century, the 'over-65' population of Americans increased eight­ fold. By century's end it will have increased 12-fold and shortly thereafter will include one in five Americans. While initially a fact of the developed world, the pace of similar graying is accelerating even more rapidly in the Second and Third Worlds. This gray delta constitutes about 35 million living Americans, who may use one-half or more of the health care resources. A would have to be a lot more foolish than B if they failed to recognize that in the coming decade the causation, case-mix, and area of the gray delta demands a change from early, mid-or even later-century medicine. If Homer Smith was right in saying, "We are what we are because we have the kind of kidneys we have" and "The kidneys make the stuff of philosophy", then the who, what, where, when, and why the gray delta will be cared for must focus on the stuff of geriatric nephrology.

one The Aging Process.- 1. The Aging Process and Geriatric Principles.- 2. Changes in Renal Function with Age.- 3. Renal Consultations in Hospitalized Very Old People.- two Progression of Renal Diseases.- 4. Progression of Glomerular Diseases: Risk Factors and Clinical Overview.- 5. Progression of Glomerular Sclerosis: Molecular and Immunologic Mechanisms.- 6. Renal Complications of Non-steroidal Anti-inflammatory Drugs in Older People.- 7. Treatment of Hyperlipidemia in the Elderly.- three Parenchymal Renal Diseases.- 8. Glomerulonephritis in the Elderly.- 9. Renal Vasculitis in the Elderly.- 10. Maturity-Onset Diabetes and Nephropathy.- four Water and Electrolyte Problems in the Elderly.- 11. Clinical Approach to Volume Overload: Predicting the Vulnerable Patient.- five Urinary Tract Infection.- 12. Urinary Infection in the Elderly.- 13. Urinary-Tract Infection in the Elderly: Evaluation and Treatment.- 14. Urinary-Tract Infection in the Elderly, Epidemiology and Pathogenesis.- six Hypertension.- 15. Hypertension in the Elderly: Pathophysiology of Aging of the Cardiovascular System.- 16. Pathophysiology of Hypertension in the Elderly.- 17. Treatment of Hypertension in the Elderly.- seven Acute Renal Failure.- 18. Risk Factors for Acute Renal Failure in the Elderly.- 19. Recognition and Prevention of Drug-Induced Acute Renal Failure.- 20. Contrast-Induced Renal Failure in the Elderly.- eight The Elderly Patient on Dialysis.- 21. Selection of Dialysis Mode in the Elderly with End-Stage Renal Disease.- 22. Hemodialysis of the Elderly.- 23. Creative Strategies for Chronic Peritoneal Dialysis in the Elderly.- 24. Hemodialysis in a Chronic Care Facility.- 25. Peritoneal Dialysis in the Nursing-Home Patient.- 26. Aluminum Intoxication in the Elderly Dialysis Patient.- 27. Angioaccess for Hemodialysis in Patients 65 Years and Older.- 28. Outcomes of CAPD Versus Hemodialysis in the Elderly.- 29. Quality of Life for Elderly Dialysis Patients: Effects of Race and Mode of Dialysis.- 30. Rehabilitation of Elderly Patients on Hemodialysis.- 31. Geriatric Rehabilitation in the Elderly with End-Stage Renal Disease.- 32. Surrogates of Nutritional Status as Prognostic Indicators for Elderly Hemodialysis Patients.- 33. Nutrition in the Elderly CAPD Patient.- 34. 'You Can't Teach an Old Dog New Tricks'.- 35. Challenges in the Training of Elderly CAPD Patients.- nine Renal Transplantation.- 36. Host Resistance and Immune System.- 37. Complications and Preparation of the Elderly Recipient for Transplantation.- 38. Renal Transplantation in the Elderly: The Toronto Experience.- ten Urinary Incontinence.- 39. Epidemiology of Urinary Incontinence in the Elderly.- 40. Surgical Treatment of Stress-Urinary Incontinence.- 41. Pharmacologic Challenges to Treatment for Urinary Incontinence.- 42. Behavioral Program for Urinary Incontinence: Indications, Techniques and Results.- 43. Behavioral Programs for Urinary Incontinence: Pelvic Muscle Exercise and Prompted Voiding.- eleven Bladder Cancer.- 44. Treatment of Metastatic Bladder Cancer in the Elderly.- 45. Radiation in Muscle-Invasive Bladder Cancer.- twelve Sexual Dysfunction.- 46. The Diagnosis of Impotence.- 47. Pharmacological Treatment of Male Sexual Dysfunction.- 48. Non-Prosthetic Treatment of Male Sexual Dysfunction.- 49. Prosthetic Treatment of Male Sexual Dysfunction.- thirteen Prostatic Diseases.- 50. Prostate Cancer: Defining the Challenges.- 51. Early Detection of Prostate Cancer.- 52. Prostatic-Specific Antigen in the Diagnosis, Staging and Management of Adenocarcinoma of the Prostate.- 53.Transrectal Prostate Ultrasound: Strengths and Limitations.- 54. Transurethral Prostatectomy.- 55. Benign Prostatic Hyperplasia: Pathogenesis and the Role of Medical Management.- 56. Alpha Blockade in the Therapy of Benign Prostatic Hyperplasia.- 57. Flutamide in Benign Prostatic Hyperplasia.- 58. Non-Medical Alternative Therapy in Benign Prostatic Hyperplasia.- fourteen Ethical Issues.- 59. Advance Directives for Health Care.- 60. The Oregon Health Plan.- 61. Stopping Dialysis - Different Views.- 62. Exclusion of Old Patients From Dialysis in USA, Canada and Sweden.- 63. Decision to Forgo ESRD Treatment.- 64. Allocation of Scarce Resources: Justice and Rationing of Health Care.- 65. The Canadian Health Care System.