title: The impact of type of assistance on characteristics of peritonitis in elderly peritoneal dialysis patients.
abstract: 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.
authors.affiliation: Department of Nephrology, Chang Gung Memorial Hospital and School of Medicine, Chang Gung University, No. 5, Fu-Shing Street, Kueishan, Taoyuan County, 333, Taiwan.
authors.forename: Chun-Yih
authors.initials: CY
authors.lastname: Hsieh
authors.forename: Ji-Tseng
authors.initials: JT
authors.lastname: Fang
authors.forename: Chih-Wei
authors.initials: CW
authors.lastname: Yang
authors.forename: Ping-Chin
authors.initials: PC
authors.lastname: Lai
authors.forename: Sau-An
authors.initials: SA
authors.lastname: Hu
authors.forename: Yu-Ming
authors.initials: YM
authors.lastname: Chen
authors.forename: Chun-Chen
authors.initials: CC
authors.lastname: Yu
authors.forename: Ya-Chung
authors.initials: YC
authors.lastname: Tian
authors.forename: Chu-Chun
authors.initials: CC
authors.lastname: Chien
authors.forename: Cheng-Chieh
authors.initials: CC
authors.lastname: Hung
mesh_terms: 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