Peritoneal dialysis in nondiabetic patients older than 70 years: comparison with patients aged 40 to 60 years.
In all industrial countries, the number of elderly patients who need dialysis has increased in recent years. In the present study, we retrospectively analyzed two different age groups of nondiabetic peritoneal dialysis patients treated at the same unit by the same team of physicians and nurses with the same protocols. However, our purpose was to study possible differences in technique and survival rates, causes of dropout, complications, hospitalization rate, and everyday needs between the two groups. The results of 63 consecutive nondiabetic patients older than 70 years treated with continuous ambulatory peritoneal dialysis (CAPD) were compared with those of 86 nondiabetic patients aged 40 to 60 years treated during the same period. Patient survival was significantly worse in the elderly patients, but the observed to expected survival ratio with respect to age was similar. Technique survival was comparable in the two groups. Total hospitalization was 5,501 days (32 d/yr) in the elderly patients and 4,511 days (18 d/yr; P < 0.05) in the younger group. The peritonitis rate was 0.52 episodes/patient-year in the elderly patients and 0.37 episodes/patient-year in the younger patients (P < 0.002). The exit site infection rate was similar in the two groups (0.30 episodes/yr v0.29 episodes/yr). Other complications related to CAPD did not differ between the elderly and younger patients. Rehabilitation and biochemical data after 1 year of CAPD were similar in the two groups of patients. After 1 year of treatment, 12% of the younger patients and 43% of the elderly patients (P < 0.005) needed a partner for dialysis. Twenty-nine of 39 (74%) of the elderly patients and 30 of 53 (57%) of the younger patients considered their lifestyle acceptable after 1 year of dialysis. Thirty-four of 39 (87%) of the elderly patients and 32 of 53 (60%) of the younger patients (P < 0.02) rated their physical and social state after rehabilitation as better or comparable to that they had before terminal uremia.
De Vecchi
A F
AF
Division of Nephrology and Dialysis, IRCCS Ospedale Maggiore, Milan, Italy.
Maccario
M
M
Braga
M
M
Scalamogna
A
A
Castelnovo
C
C
Ponticelli
C
C
D000328:Adult; D000367:Age Factors; D000368:Aged; D001424:Bacterial Infections / Q000209:etiology; D002408:Catheters, Indwelling / Q000009:adverse effects; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008875:Middle Aged; D009752:Nutritional Status; D010352:Patient Dropouts; D010531:Peritoneal Dialysis, Continuous Ambulatory / Q000009:adverse effects / Q000401:mortality; D010538:Peritonitis / Q000209:etiology; D011788:Quality of Life; D012189:Retrospective Studies; D012307:Risk Factors; D015996:Survival Rate