title: Prognostic survival factors in elderly renal failure patients treated with peritoneal dialysis: a nine-year retrospective study.
abstract: BACKGROUND
  Few studies specifically investigating elderly patients on peritoneal dialysis (PD) have been conducted and great uncertainty remains on the factors involved in the vital prognosis. The objective of this study was to describe our population of patients aged 75 years or older at the time PD was initiated and to study their survival in terms of the relevant nephro-geriatric criteria inventoried at the beginning of treatment.
  
  
  METHODS
  We retrospectively analyzed the data of all the elderly patients that began first-line PD in our center between 1 January 1997 and 31 July 2006 (n = 112).
  
  
  RESULTS
  Mean duration of survival on PD was 19.6 +/- 13.9 months; by the end of the study 87 patients had died and 7 had been transferred to hemodialysis. The Cox model multivariate analysis of survival allowed us to select 5 independent predictive variables that had a considerable impact on survival: absence of nephrologic care before dialysis, associated comorbidities (Charlson Comorbidity Index), loss of physical and/or mental autonomy (AGGIR group), and polymedication. Above and beyond the weight of these clinical variables, institutionalization or, more generally, social isolation was a determining factor for the duration of survival in PD.
  
  
  CONCLUSIONS
  Any patient considered for peritoneal dialysis should be evaluated by a multidisciplinary team in collaboration with geriatric specialists for both the overall medical situation and the social and family environment.
authors.affiliation: Service de Néphrologie, Hôpital Pasteur, Colmar, France. sandrine.genestier@aub-sante.fr
authors.forename: Sandrine
authors.initials: S
authors.lastname: Genestier
authors.forename: Nicolas
authors.initials: N
authors.lastname: Meyer
authors.forename: François
authors.initials: F
authors.lastname: Chantrel
authors.forename: Farideh
authors.initials: F
authors.lastname: Alenabi
authors.forename: Pierre
authors.initials: P
authors.lastname: Brignon
authors.forename: Mehadji
authors.initials: M
authors.lastname: Maaz
authors.forename: Sandrine
authors.initials: S
authors.lastname: Muller
authors.forename: Bernadette
authors.initials: B
authors.lastname: Faller
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008297:Male; D015999:Multivariate Analysis; D010530:Peritoneal Dialysis; D011379:Prognosis; D051437:Renal Insufficiency / Q000401:mortality* / Q000628:therapy*; D012189:Retrospective Studies; D015996:Survival Rate; D013997:Time Factors