Ulutas Ozkan, Farragher Janine, Chiu Ernest, Cook Wendy L, Jassal Sarbjit V
Division of Nephrology, University Health Network, Toronto Division of Nephrology, Faculty of Medicine, Inonu University, Malatya, Turkey.
Division of Nephrology, University Health Network, Toronto.
Perit Dial Int. 2016 Jan-Feb;36(1):71-8. doi: 10.3747/pdi.2013.00293. Epub 2014 Apr 7.
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Older in-center hemodialysis patients have a high burden of functional disability. However, little is known about patients on home chronic peritoneal dialysis (PD). As patients opting for home dialysis are expected to play a greater role in their own dialysis care, we hypothesized that a relatively low number of PD patients would require help with basic self-care tasks (ADL) and instrumental activities of daily living (IADL). ♦
We used a cross-sectional study design to measure the proportion of patients aged 65 years and older undergoing outpatient PD who needed help with day-to-day activities. Patients living in nursing homes were excluded from the study. Functional dependence in ADL and IADL tasks were measured by the Barthel and Lawton Scales. Physical performance measures used included the timed up-and-go (TUG) test, chair stands and Folstein mini-mental score (MMSE). ♦
A total of 74 of 76 (97%) eligible PD patients participated. Patients had a mean age of 76.2 ± 7.5 years. Thirty-six percent had impaired MMSE scores, 69% were unable to stand from a chair without the use of their arms and 51% had abnormal TUG scores. Only 8 patients (11%) were fully independent for both ADL and IADL activities. Dependence in one or more ADL activity was reported by 64% of participants, while 89% reported dependence in one or more IADL. ♦
Impaired physical and functional performance is common in older patients maintained on PD. Collaborative geriatric-renal programs may be beneficial within the dialysis community.
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老年中心血液透析患者存在较高的功能残疾负担。然而，对于居家慢性腹膜透析（PD）患者的情况却知之甚少。由于选择居家透析的患者预计要在自身透析护理中发挥更大作用，我们推测需要基本自我护理任务（ADL）和日常生活工具性活动（IADL）帮助的PD患者数量相对较少。♦
我们采用横断面研究设计，以测量65岁及以上接受门诊PD治疗且在日常活动中需要帮助的患者比例。住在养老院的患者被排除在研究之外。ADL和IADL任务中的功能依赖性通过巴氏量表和洛顿量表进行测量。所使用的身体表现测量方法包括定时起立行走（TUG）测试、从椅子上站起测试和福尔斯坦简易精神状态评分（MMSE）。♦
76名符合条件的PD患者中有74名（97%）参与了研究。患者的平均年龄为76.2±7.5岁。36%的患者MMSE评分受损，69%的患者不借助手臂无法从椅子上站起来，51%的患者TUG测试结果异常。只有8名患者（11%）在ADL和IADL活动方面完全独立。64%的参与者报告在一项或多项ADL活动中存在依赖，而89%的参与者报告在一项或多项IADL中存在依赖。♦
接受PD治疗的老年患者身体和功能表现受损很常见。在透析社区内开展老年肾脏协作项目可能会有益处。
