title: Clinical outcomes and mortality in elderly peritoneal dialysis patients.
abstract: OBJECTIVE
  To evaluate the clinical outcomes and identify the predictors of mortality in elderly patients undergoing peritoneal dialysis.
  
  
  METHODS
  We conducted a retrospective study including all incident peritoneal dialysis cases in patients ≥65 years of age treated from 2001 to 2014. Demographic and clinical data on the initiation of peritoneal dialysis and the clinical events during the study period were collected. Infectious complications were recorded. Overall and technique survival rates were analyzed.
  
  
  RESULTS
  Fifty-eight patients who began peritoneal dialysis during the study period were considered for analysis, and 50 of these patients were included in the final analysis. Peritoneal dialysis exchanges were performed by another person for 65% of the patients, whereas 79.9% of patients preferred to perform the peritoneal dialysis themselves. Peritonitis and catheter exit site/tunnel infection incidences were 20.4±16.3 and 24.6±17.4 patient-months, respectively. During the follow-up period, 40 patients were withdrawn from peritoneal dialysis. Causes of death included peritonitis and/or sepsis (50%) and cardiovascular events (30%). The mean patient survival time was 38.9±4.3 months, and the survival rates were 78.8%, 66.8%, 50.9% and 19.5% at 1, 2, 3 and 4 years after peritoneal dialysis initiation, respectively. Advanced age, the presence of additional diseases, increased episodes of peritonitis, the use of continuous ambulatory peritoneal dialysis, and low albumin levels and daily urine volumes (<100 ml) at the initiation of peritoneal dialysis were predictors of mortality. The mean technique survival duration was 61.7±5.2 months. The technique survival rates were 97.9%, 90.6%, 81.5% and 71% at 1, 2, 3 and 4 years, respectively. None of the factors analyzed were predictors of technique survival.
  
  
  CONCLUSIONS
  Mortality was higher in elderly patients. Factors affecting mortality in elderly patients included advanced age, the presence of comorbid diseases, increased episodes of peritonitis, use of continuous ambulatory peritoneal dialysis, and low albumin levels and daily urine volumes (<100 ml) at the initiation of peritoneal dialysis.
authors.forename: Tamer
authors.initials: T
authors.lastname: Sakacı
authors.forename: Elbis
authors.initials: E
authors.lastname: Ahbap
authors.forename: Yener
authors.initials: Y
authors.lastname: Koc
authors.forename: Taner
authors.initials: T
authors.lastname: Basturk
authors.forename: Zuhal Atan
authors.initials: ZA
authors.lastname: Ucar
authors.forename: Ayse
authors.initials: A
authors.lastname: Sınangıl
authors.forename: Mustafa
authors.initials: M
authors.lastname: Sevınc
authors.forename: Ekrem
authors.initials: E
authors.lastname: Kara
authors.forename: Cuneyt
authors.initials: C
authors.lastname: Akgol
authors.forename: Arzu Ozdemır
authors.initials: AO
authors.lastname: Kayalar
authors.forename: Feyza Bayraktar
authors.initials: FB
authors.lastname: Caglayan
authors.forename: Tuncay
authors.initials: T
authors.lastname: Sahutoglu
authors.forename: Abdulkadir
authors.initials: A
authors.lastname: Ünsal
mesh_terms: D000368:Aged; D000418:Albumins / Q000032:analysis; D001938:Brazil / Q000453:epidemiology; D055499:Catheter-Related Infections / Q000150:complications; D002423:Cause of Death; D003404:Creatinine / Q000097:blood; D003929:Diabetic Neuropathies / Q000150:complications / Q000628:therapy*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007676:Kidney Failure, Chronic / Q000150:complications / Q000401:mortality* / Q000628:therapy* / Q000652:urine; D008297:Male; D010530:Peritoneal Dialysis / Q000379:methods* / Q000401:mortality; D010531:Peritoneal Dialysis, Continuous Ambulatory / Q000009:adverse effects; D010538:Peritonitis / Q000150:complications / Q000401:mortality; D012189:Retrospective Studies; D018805:Sepsis / Q000150:complications / Q000401:mortality; D015996:Survival Rate; D016896:Treatment Outcome
chemical_list: D000418:Albumins; D003404:Creatinine