The impact of type of assistance on characteristics of peritonitis in elderly peritoneal dialysis patients.
BACKGROUND
The elderly patients are the fastest-growing end-stage renal disease (ESRD) population in Taiwan. Assisted peritoneal dialysis (PD) has been employed to overcome the barriers to PD. The aim of this retrospective, single-center study was to describe the status of assisted PD and the impact of type of assistance on peritonitis in elderly patients in Taiwan.


METHODS
One hundred and two patients initiated PD at the age of 65 or older between 2000 and 2008; 79 episodes of peritonitis occurred during the follow-ups. The patients and episodes of peritonitis were divided into three groups based on the type of assistance: (1) self-care: patients performing dialysis independently, (2) family: patients whose dialysis was performed by family, (3) caregiver: patients whose dialysis was performed by a private caregiver. Patient characteristics and incidence, etiology and outcomes of peritonitis were compared.


RESULTS
There were 26 (25.5%), 44 (43.1%), and 32 (31.4%) patients in the self-care, family, and caregiver groups, respectively. The overall peritonitis rate was 1/33 patient-months. Patients in the caregiver group were older and had more comorbidities than the self-care group. They had a trend of higher overall peritonitis rate (1/24 patient-months, P = 0.077) and fungal peritonitis rate (P = 0.060) compared to the self-care and family groups, but this was statistically non-significant.


CONCLUSIONS
Three-fourths of elderly PD patients in the present study required assistance from family members or private caregivers. Caregiver-assisted patients were significantly older and had more comorbidities. Also, a non-significant trend of higher peritonitis incidence was observed in these patients.
Hsieh
Chun-Yih
CY
Department of Nephrology, Chang Gung Memorial Hospital and School of Medicine, Chang Gung University, No. 5, Fu-Shing Street, Kueishan, Taoyuan County, 333, Taiwan.
Fang
Ji-Tseng
JT
Yang
Chih-Wei
CW
Lai
Ping-Chin
PC
Hu
Sau-An
SA
Chen
Yu-Ming
YM
Yu
Chun-Chen
CC
Tian
Ya-Chung
YC
Chien
Chu-Chun
CC
Hung
Cheng-Chieh
CC
D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008297:Male; D010530:Peritoneal Dialysis; D010538:Peritonitis / Q000453:epidemiology / Q000209:etiology / Q000628:therapy; D012189:Retrospective Studies