Clinical outcomes and quality of life in elderly patients on peritoneal dialysis versus hemodialysis.
OBJECTIVE
To compare clinical outcomes and quality of life (QOL) in elderly patients on peritoneal dialysis (PD) and hemodialysis (HD) in the North Thames Dialysis Study.


METHODS
A 12-month prospective cohort study.


METHODS
Four hospital-based renal units in London, UK.


METHODS
174 patients that were 70 years or older at the start of dialysis, separated into two cohorts: 78 new patients (36 PD, 42 HD) that were recruited after 90 days of chronic dialysis; and 96 stock patients (42 PD, 54 HD) that were already on dialysis during the recruitment period.


METHODS
12-month survival and hospitalization rate, and QOL assessed at baseline and at 6 and 12 months by the SF-36 and the Symptoms/Problems scale of the Kidney Disease Quality of Life Questionnaire (KDQOL).


RESULTS
Peritoneal dialysis and HD patients were similar for sociodemographic and clinical characteristics. Annual mortality and hospitalization rates in PD versus HD patients were 26.1 versus 26.4 deaths/100 person-years and 1.9 versus 2.0 admissions/person-year, respectively. Adjusted relative risks showed no effect of modality on clinical outcomes. Multiple linear regression analyses of QOL at baseline showed similar SF-36 scores between PD and HD patients, but higher KDQOL scores in PD patients (3.5 points higher, 95% confidence interval 0.3-6.6). There was, however, no effect of dialysis modality on QOL at 6 or 12 months.


CONCLUSIONS
Clinical outcomes and QOL are similar in elderly people on PD and HD. Peritoneal dialysis is a viable option for more than a carefully selected minority of elderly people requiring dialysis.
D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D005260:Female; D006760:Hospitalization; D006801:Humans; D007676:Kidney Failure, Chronic / Q000401:mortality / Q000523:psychology* / Q000628:therapy*; D008297:Male; D017063:Outcome Assessment, Health Care; D010530:Peritoneal Dialysis / Q000523:psychology*; D011446:Prospective Studies; D011581:Psychological Tests; D011788:Quality of Life / Q000523:psychology*; D006435:Renal Dialysis / Q000523:psychology*; D015996:Survival Rate; D013997:Time Factors