Holley J L, Foulks C J
Renal Electrolyte Division, University of Pittsburgh, PA.
Perit Dial Int. 1991;11(2):162-5.
The elderly comprise an increasing proportion of chronic dialysis patients. Recruiting them for continuous peritoneal dialysis (CPD) would help CPD programs maintain a patient population. We retrospectively studied the ability of a prospective evaluation to predict success with CPD in elderly (age greater than 60 years) patients. PD nurses and a renal social worker assigned scores in 10 categories, which were then averaged to obtain an over-all evaluation score. Scores were from 1-5 with 1 = good, 5 = poor, and 3 = average. Thirty-four elderly patients began CPD during the study period. Evaluation scores were available for 28 of these patients before they began dialysis. Evaluation scores less than 3 predicted success with CPD (2.2 +/- 0.2 versus 3.2 +/- 0.4 in patients transferring to hemodialysis, p less than 0.02). Patient motivation and preference were the categories that predicted success with CPD. Elderly patients were more likely than younger patients (those less than 60 years of age) to decline CPD for social reasons (46% versus 4% respectively, p less than 0.001). Elderly patients required more CPD training time than young patients (4.9 +/- 0.7 days versus 3.3 +/- 0.8 days respectively, p less than 0.01). We conclude that a prospective assessment of elderly patients can predict success with CPD and provide information important to individual structuring of CPD training and follow-up.
老年患者在慢性透析患者中所占比例日益增加。招募他们接受持续腹膜透析（CPD）将有助于CPD项目维持患者群体数量。我们回顾性研究了一项前瞻性评估预测老年（年龄大于60岁）患者CPD成功的能力。腹膜透析护士和肾脏社会工作者在10个类别中进行评分，然后将其平均以获得总体评估分数。评分范围为1至5分，其中1分代表良好，5分代表差，3分代表中等。在研究期间，34名老年患者开始接受CPD。其中28名患者在开始透析前有评估分数。评估分数低于3分预测CPD成功（转为血液透析的患者为2.2±0.2分，而转为血液透析的患者为3.2±0.4分，p<0.02）。患者的积极性和偏好是预测CPD成功的类别。老年患者因社会原因拒绝CPD的可能性比年轻患者（年龄小于60岁）更高（分别为46%和4%，p<0.001）。老年患者比年轻患者需要更多的CPD培训时间（分别为4.9±0.7天和3.3±0.8天，p<0.01）。我们得出结论，对老年患者进行前瞻性评估可以预测CPD的成功，并为CPD培训和随访的个体化安排提供重要信息。
