Elderly diabetic patients on peritoneal dialysis

Area of Science:

• Nephrology
• Diabetology
• Geriatrics

Background:

• Diabetes mellitus is the fastest-growing cause of end-stage renal disease (ESRD).
• The number of elderly patients requiring renal replacement therapy (RRT) has increased significantly.
• Peritoneal dialysis (PD) is less commonly used than hemodialysis for elderly diabetic patients.

Purpose of the Study:

• To evaluate the viability and outcomes of peritoneal dialysis (PD) for elderly patients with end-stage renal disease (ESRD) and diabetes mellitus.
• To compare the survival rates of elderly diabetic patients on PD versus hemodialysis.
• To identify factors influencing mortality in this patient population.

Main Methods:

• Review of existing literature and data on elderly diabetic patients undergoing RRT.
• Analysis of survival rates and associated comorbidities in PD and hemodialysis cohorts.
• Exploration of potential reasons for differential outcomes across countries.

Main Results:

• Elderly diabetic patients on PD historically had lower survival rates compared to non-diabetic or younger diabetic patients, potentially due to higher comorbidity.
• Diabetic patients on RRT face increased risks of cardiovascular disease, a major cause of mortality.
• Survival rates for elderly diabetic patients on PD have shown significant improvement in recent years, with outcomes comparable to hemodialysis in some regions (e.g., Canada).

Conclusions:

• Peritoneal dialysis (PD) is a viable long-term renal replacement therapy (RRT) option for elderly patients with end-stage renal disease (ESRD) and diabetes mellitus.
• While challenges exist, including higher comorbidity and cardiovascular risks, recent advancements have improved PD outcomes in this demographic.
• Fluid volume management may be a critical factor in optimizing PD outcomes for elderly diabetic patients.