Imperial College Kidney and Transplant Centre, Hammersmith Hospital, London, UK. e.a.brown @ imperial.ac.uk
Nephron Clin Pract. 2011;119 Suppl 1:c10-3. doi: 10.1159/000328019. Epub 2011 Aug 10.
The numbers of older patients requiring dialysis therapy is rising, reflecting the ageing of the general population. Older dialysis patients have a tendency to present later for dialysis, have a higher number of comorbid conditions, are at higher risk of cognitive dysfunction and have increased levels of frailty. These are all barriers to home dialysis therapy so hospital haemodialysis (HD) is the predominant dialysis modality for older patients. Evidence suggests, however, that home treatment with peritoneal dialysis (PD) intrudes less into the life of older patients than hospital HD. Assisted PD is available in some countries and this enables more older patients to be treated in their own homes. Adjustments to patient education also need to be made to accommodate the barriers to learning and decision-making that often exist in older people.
需要透析治疗的老年患者人数正在增加，这反映了人口老龄化。老年透析患者往往较晚开始透析，合并症较多，认知功能障碍风险较高，身体虚弱程度更高。这些都是居家透析治疗的障碍，因此医院血液透析（HD）是老年患者的主要透析方式。然而，有证据表明，与医院 HD 相比，家庭腹膜透析（PD）治疗对老年患者的生活干扰更小。在一些国家，辅助 PD 是可用的，这使得更多的老年患者能够在家中接受治疗。还需要对患者教育进行调整，以适应老年人学习和决策方面经常存在的障碍。
