Prognostic predictors of technique and patient survival in elderly Southeast Asian patients undergoing continuous ambulatory peritoneal dialysis

Abstract

The population of elderly patients entering chronic dialysis programmes is increasing. Elderly patients are susceptible to malnutrition and have multiple complicating disorders in addition to uraemia. Selecting appropriate dialysis modality is particularly critical in elderly patients. Continuous ambulatory peritoneal dialysis (CAPD) has many advantages to elderly patients; however, the clinical outcome varies for elderly CAPD patients. In comparison with Westerners, Southeast Asians have a small body mass index and may be more suited to CAPD therapy. To identify the prognostic predictors in elderly Southeast Asian patients, this historical cohort study analysed 144 patients aged > or = 65 years at initiation of CAPD. A group of haemodialysis (HD) patients aged > or = 65 years was utilised as the control group. Survival curves for patient and technique were derived from Kaplan-Meier analysis and were further analysed by Cox-Mantel log-rank test. To elucidate the impact of individual factors on patient survival, various significant univariables were further subjected to multivariate analysis. No significant increase existed for relative risk of technique failure in elderly patients compared with younger patients. This analytical data indicates that CAPD was as good as HD for elderly uraemic patients regarding to the patient survival. Diabetes, dependent patients, low albumin levels and previous HD history were significant poor prognostic factors for survival of elderly CAPD patients. In conclusion, CAPD is an effective modality of renal replacement therapy for Southeast Asian elderly patients. The technique survival was not affected by patient age.

Geografia da diálise peritoneal no Brasil: análise de uma coorte de 5.819 pacientes (BRAZPD)

“…13 When evaluating the survival of patients during the period in the Southeast (76.7%), South (79.3%), Northeast (86.6%), Midwest (88.5%) and North (69.9%) regions, we can observe that it is similar and comparable to the studies published in developed countries. The technique survival is also satisfactory in the period in the Southeast (83.4%), South (82.3%), Northeast (83.2%), Midwest (89.2%) and North (77.7%) regions and comparable to large studies published in the literature [14][15][16][17][18]19 (Table 1, Figures 1 and 2).…”

Prognostic Survival Factors in Elderly Renal Failure Patients Treated with Peritoneal Dialysis: A Nine-Year Retrospective Study

“…With an at least equivalent result in terms of survival during the first years of treatment, PD has a certain number of benefits compared to HD (4)(5)(6)(7). Some of these advantages are medical: the absence of vascular access, longer preservation of residual renal function, and better hemodynamic tolerance.…”

Early Peritonitis is an Independent Risk Factor for Mortality in Elderly Peritoneal Dialysis Patients

“…Because of its hemodynamic stability, home-based treatment options and better protection of residual renal function, numerous elderly patients choose peritoneal dialysis (PD) to treat renal failure [1,2]. Numerous studies demonstrate that older age, poor nutrition, comorbidities, and peritonitis are risk factors for mortality in elderly PD patients [3,4]. Although previous studies have demonstrated similar risks of peritonitis in elderly and younger patients, the risk of peritonitis in elderly PD patients has been a particular concern [5].…”