Incidence, Prevalence, and Outcomes of End-Stage Renal Disease Patients Placed in Nursing Homes

Anderson, John E.; Kraus, Joanne Fritz; Sturgeon, Delaney

doi:10.1016/s0272-6386(12)80034-5

Cited by 37 publications

(33 citation statements)

References 14 publications

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“…Carey et al who studied the outcomes of 93 CAPD patients in ten community extended care facilities over a 5-year period, observed 6-and 12-month survival rates of 50% and 40%, respectively [53]. The same authors concluded that, when compared with age-matched patients in the community who experienced one peritonitis episode per 13.5 patient/ months, nursing home patients have a higher risk of peritonitis, with one episode per 9.6 patient-months [51][52][53]. Higher incidence of peritonitis in nursinghome patients was confirmed by others (1 episode per 7.54 patient-months) [54].…”

Section: Assisted Peritoneal Dialysismentioning

confidence: 99%

“…The 1997 National Nursing Home Survey found that there were nearly 1.5 million residents [65 years old living in nursing homes in the USA [49]. Of these nursing home patients, 0.3% were on dialysis, approximately 90% of these were on hemodialysis, and 10% were on peritoneal dialysis [50].…”

Section: Assisted Peritoneal Dialysismentioning

confidence: 99%

“…Patients on PD in nursing homes and day-care centers have lower survival than the general CAPD population, which is probably a reflection of patient selection because those in nursing homes are significantly older and have many comorbid conditions. Anderson et al did a retrospective analysis initially of 44, and later of 109 nursing home patients on CAPD over a 10-year period [51,52]. Survival rates at 6 and 12 months were 51.7% and 37.2%, respectively.…”

Section: Assisted Peritoneal Dialysismentioning

confidence: 99%

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Assisted peritoneal dialysis as a method of choice for elderly with end-stage renal disease

Dimković

Oreopoulos

2008

Int Urol Nephrol

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In the last two decades, most developed countries have seen a continuous growth in the number of elderly patients with end-stage renal disease commencing renal replacement therapy. Despite the many advantages that peritoneal dialysis (PD) offers to elderly patients with ESRD, it is still underutilized in older patients. Older patients are much more vulnerable to the problems associated with aging, which may affect their level of independence and their long-term prognosis. Those patients have physiological changes related to aging and common health problems such as anxiety, depression, dementia, visual impairment, and cognitive impairment, all of which interfere with self-performing PD. Assistance with home-care nurses and assistance by a family member may overcome this problem. Some old but also more recent literature data justifies the idea that assisted PD may significantly contribute to increase the overall number of elderly patients who can be treated with PD at home. With assisted PD, free choice can be offered to patients with high comorbidity index who cannot perform their peritoneal exchanges by themselves. Automated peritoneal dialysis is the ideal treatment modality for elderly patients with end-stage renal disease who require assistance since this limits home-care nurse visits to only two a day. As expected, the elderly have a higher mortality rate than younger patients treated by assisted PD, but technique failure rate, overall peritonitis rate, and most quality-of-life (QoL) measures are comparable with those of younger patients. Peritoneal dialysis in nursing homes offers treatment for elderly patients without family support. In this regard, automated PD or nightly PD keeps the patient's daytime free for nursing home activities, increases socialization, and enables better rehabilitation that improves their QoL. Although withdrawal from dialysis is more frequent among nursing-home dialysis patients, this high discontinuation rate is not due to dialysis per se but rather to associated social and medical circumstances. Better communication between nursing staff and renal team is crucial for improving staff confidence and will contribute to higher utilization of PD in nursing homes.

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Section: Assisted Peritoneal Dialysismentioning

confidence: 99%

Section: Assisted Peritoneal Dialysismentioning

confidence: 99%

Section: Assisted Peritoneal Dialysismentioning

confidence: 99%

See 1 more Smart Citation

Assisted peritoneal dialysis as a method of choice for elderly with end-stage renal disease

Dimković

Oreopoulos

2008

Int Urol Nephrol

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“…Survival analysis using the Cox model showed that patients with a better functional status on admission, as measured by activity of daily living scores, and who had previously been in an outpatient dialysis program before admission survived longer and were more often discharged. In 1993, Anderson et al [18] did a prospective survey of 156 dialysis centers to determine whether they had admitted end-stage renal disease (ESRD) patients or had begun dialysis in a nursing home during a 21-month period. They identified 228 NH patients treated with CAPD and found a survival rate of 38 and 27% for six and 12 months [15].…”

Section: Discussionmentioning

confidence: 99%

“…Despite increasing demand for dialysis for patients residing in an NH setting, the literature contains little data concerning the characteristics and outcomes of these patients and even less information concerning the delivery of dialysis in the NH [15][16][17][18][19][20][21].…”

Section: Introductionmentioning

confidence: 99%