title: How to address barriers to peritoneal dialysis in the elderly.
abstract: Older patients on dialysis have unique needs and characteristics and their outcomes vary from that of their younger counterparts. Comparatively fewer will start or be maintained on peritoneal dialysis (PD) compared to younger patients, despite the fact that hemodialysis is often poorly tolerated. Barriers to PD for older patients include poor vision, frailty, cognitive dysfunction, accommodation issues, and a bias from renal teams that older patients cannot do PD. The development of assisted PD can overcome many of these barriers. The ability of older patients to use PD as their dialysis modality should not be determined by whether they live in an area where the nephrologist is a PD enthusiast. All patients should be given nonbiased information so they can choose the dialysis modality that gives them the best quality of life and suits their and their family's lifestyle.
authors.affiliation: Imperial College Kidney and Transplant Institute, Hammersmith Hospital, Du Cane Road, London, United Kingdom. e.a.brown@imperial.ac.uk
authors.forename: Edwina A
authors.initials: EA
authors.lastname: Brown
mesh_terms: D022126:Access to Information; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D001291:Attitude of Health Personnel; D002755:Choice Behavior; D003072:Cognition Disorders / Q000150:complications; D054626:Consumer Health Information; D005260:Female; D016330:Frail Elderly; D006297:Health Services Accessibility; D006299:Health Services for the Aged; D006311:Hearing Disorders / Q000150:complications; D006699:Home Care Services / Q000191:economics; D006801:Humans; D008019:Life Style; D008297:Male; D010353:Patient Education as Topic; D010358:Patient Participation; D010530:Peritoneal Dialysis / Q000191:economics / Q000451:nursing / Q000706:statistics & numerical data; D011788:Quality of Life; D014786:Vision Disorders / Q000150:complications