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Peritoneal dialysis in the geriatric patient
A R Nissenson1, J A Diaz-Buxo, A Adcock
1Department of Medicine, UCLA School of Medicine.
Summary
Elderly patients on chronic peritoneal dialysis (CPD) tolerate the treatment well, with similar peritonitis rates to younger patients. While some differences exist after the first year, CPD is a viable renal replacement therapy for older adults.
Area of Science:
- Nephrology
- Geriatric Medicine
- Renal Replacement Therapy
Background:
- Chronic peritoneal dialysis (CPD) is a common renal replacement therapy.
- Assessing treatment outcomes in elderly patients is crucial for optimizing care.
Purpose of the Study:
- To compare the outcomes of chronic peritoneal dialysis (CPD) in elderly versus younger patients.
- To evaluate peritonitis rates, catheter issues, hospitalization, and mortality in different age groups.
Main Methods:
- Retrospective comparison of elderly and younger patients undergoing CPD.
- Analysis of peritonitis rates, causative organisms, catheter complications, hospitalizations, and mortality.
- Comparison of modality transfers and survival rates.
Main Results:
- Peritonitis rates and organisms were comparable between elderly and younger CPD patients.
- Elderly patients experienced fewer catheter replacements but had more hospital days, primarily for vascular disease.
- After the first year of continuous ambulatory peritoneal dialysis (CAPD), the elderly showed higher rates of first peritonitis, mortality, and modality changes, though differences were minor excluding mortality.
Conclusions:
- Chronic peritoneal dialysis (CPD) is an acceptable renal replacement therapy for elderly patients.
- While elderly patients may experience increased mortality and modality changes after the first year, overall outcomes are comparable, with manageable complications.