Survival of patients over 75 years of age on peritoneal dialysis therapy

The number of elderly patients requiring dialysis therapy has been increasing in developed countries. Among elderly patients on dialysis, the incidence of death from cardiovascular complications has increased. Our objective was to study whether the presence of abnormal cardiac function at the initiation of peritoneal dialysis (PD) affects the prognosis of patients over the age of 75 years on PD therapy. A retrospective analysis of 46 patients more than 75 years of age who started PD therapy (average age: 79.4 +/- 3.5 years; 26 women, 20 men) collected demographic and comorbidity data. Survival was defined as time from the initiation of PD therapy. In 12 patients, ejection fraction measured by echocardiography was less than 50% ("abnormal EF" group); in 34 patients, ejection fraction was more than 50% ("normal EF" group). In the abnormal EF group, 9 patients (75%) survived 12 months; in the normal EF group, 26 patients (76%) survived that long. However, at 24 months, only 2 patients (16%) in the abnormal EF group and 18 patients (52%) in the normal EF group were still alive. Survival was significantly longer in the normal EF group (p < 0.0019). With the exception of serum albumin, other parameters such as age, serum creatinine, and hemoglobin were not significantly difference between the two groups at the initiation of dialysis therapy. Our study demonstrated that cardiac performance at the initiation of PD therapy predicts prognosis in PD patients more than 75 years of age.