Peritoneal dialysis in an ageing population: a 10-year experience

Abstract

This study shows PD to be an acceptable modality of renal replacement therapy in elderly patients, with no observed differences in survival, technique survival or complication rates. Co-morbidities appear to play a stronger role in predicting survival than age alone. Assisted PD is a viable option in those unable to undergo PD independently.

Hospitalization Rates for Patients on Assisted Peritoneal Dialysis Compared with In-Center Hemodialysis

“…The assisted PD group was admitted for 11.1 hospital d/yr, which was similar to the rates in the Canadian studies by Murphy et al (20) and Lafrance et al (21) that found that patients on PD were hospitalized for 11.7 and 10.9 d/yr, respectively. This rate is lower than those in prior studies of assisted PD, which range from 18.2 to 52.6 d/yr, although these studies were small (n=22-36) and lacked comparable control groups (1,8,22). Home care assistance in Ontario, Canada is unique, because it is generously funded (two visits per day), is usually provided by registered nurses, and does not have strict eligibility criteria.…”

End-Stage Renal Disease and Renal Replacement Therapy in older Patients

“…our review of the literature shows that complication rates vary significantly. For example, our recent paper failed to show any change in overall survival or complication rates in older age groups (34). A recent Australian study reported that older patients have higher peritonitis-related and all-cause mortality rates but similar rates of peritonitis-free survival and superior-technique survival (36).…”

“…A recent Japanese study reported that cardiac performance at initiation of PD therapy is predictive of the prognosis in patients over 75 (42). our recent study reported no difference between younger and old patients who initiated PD in terms of overall survival or peritonitis-free survival but also showed a trend toward longer hospital stays in older patients (34). Although reported rates vary, overall the rates of complications or mortality do not appear to be higher in older patients who chose to perform PD (including AsPD) over hD.…”

“…A Chinese study reported AsPD to be a good option for patients with limited functional ability (33). In the Republic of Ireland, where there is no dedicated funding available to support AsPD, the treatment has been successfully employed (without any difference in PD outcomes) when there is adequate spousal or family support (34). Because AsPD provided by the family or spouse is often performed by one dedicated person, it is thought that complication rates such as exit-site infection may be similar to those utilizing independent PD.…”

Prevalence of Cognitive Impairment among Peritoneal Dialysis Patients, Impact on Peritonitis and Role of Assisted Dialysis

“…It is also increasingly common for elderly patients with ESRF to be put on assisted PD because of the presence of comorbidities including CI. Assisted PD refers to PD performed with the assistance of a family member, partner, or healthcare professional (9). There has been no study on whether assisted PD for patients with CI can achieve similar outcomes to those achieved by self-care PD patients.…”