Peritoneal dialysis in chronic renal failure patients over 65 years of age

The number of patients over 65 years of age with chronic renal failure has increased. Peritoneal dialysis (PD) is an effective mode of treatment for such patients. In the present study, we report our experience with automated PD in patients over 65. We recorded the demographic and clinical characteristics of the patients and the exit-site infection rate, the peritonitis rate, and the mortality rate, comparing those parameters with the same parameters in patients under 65. We followed 36 patients (30% of the total study population) who were over 65 years of age (mean: 74.5 +/- 7.3 years). Of the 36 patients, 34 (94.4%) had another chronic disease--arterial hypertension and heart disease being the more common. Eleven of the patients (31%) had diabetes. Duration of PD therapy in the group was 31.5 +/- 20.7 months. Ten of the patients (27.8%) had at least 1 catheter-related complication, including exit-site infection (n = 3), tunnel infection (n = 1), or a noninfectious complication (n = 6). The rate of catheter-related infection was 0.22 episodes/patient-year. Two catheter were lost: 1 in a case of hematoma, and 1 in a case of catheter obstruction. The rate of peritonitis was 0.16 episodes/patient-year, and the most common infectious agent was methicillin-susceptible Staphylococcus aureus. Actuarial survival of our elderly patients was 51.8% at 4 years of follow-up as compared with 81.7% in the younger patients (p = 0.01). All cases of death were related to comorbid conditions, not to PD therapy. Two patients were transferred to hemodialysis. We conclude that PD has proven to be a safe and comfortable therapy for renal replacement in patients over 65 years of age. Results are similar to results in younger patients.