Saka Yosuke, Naruse Tomohiko, Tawada Naoto, Tokomoto Mitsuhiro, Noda Yuhei, Taniguchi Yohei, Nagahara Yasuko, Yamashita Ryoko, Karasawa Munetoshi, Watanabe Yuzo, Ito Yasuhiko
Department of Internal Medicine, Kasugai Municipal Hospital, Takakicho 1-1-1, Kasugai, Aichi, Japan.
Department of Nephrology, Renal Replacement Therapy, Nagoya University Graduate School of Medicine, Nagoya, Japan.
Clin Exp Nephrol. 2017 Oct;21(5):919-925. doi: 10.1007/s10157-016-1374-5. Epub 2016 Dec 20.
The number of elderly dialysis patients in Japan is dramatically increasing. Receiving therapy with better satisfaction through home care is one of the important factors in their daily lives. Thus, the quality of life of elderly patients on hemodialysis (HD) or peritoneal dialysis (PD) was evaluated.
Clinical information of patients aged ≥80 years who started dialysis at our hospital between January 2013 and December 2015 was retrospectively collected. The mortality rate, length of hospitalization, and place of death were identified to evaluate patient quality of life.
In total, 56 patients (14 PD and 42 HD) were enrolled. The mean age of study subjects was 85.2 ± 4.0 years. The proportion of PD patients who lived with their family or have professional caregivers who could assist them in their daily life was higher than that of HD patients (100 vs. 76.2%, respectively; p = 0.044). Mortality rate was higher in PD patients than in HD patients (p = 0.003), but long-term hospitalization of >180 days was observed only in HD patients (PD vs. HD: 0.0 vs. 16.7%; p = 0.102). In patients with Barthel index scores <100, the long-term hospitalization difference was significant (PD vs. HD: 0.0 vs. 30.4%; p = 0.040). Of note, 6 of 7 deceased PD patients and 1 of 10 deceased HD patients died at home (p = 0.002).
PD is a desirable home care therapy for elderly patients, but the burden on caregivers should be considered.
日本老年透析患者的数量正在急剧增加。通过居家护理获得更高满意度的治疗是他们日常生活中的重要因素之一。因此，对老年血液透析（HD）或腹膜透析（PD）患者的生活质量进行了评估。
回顾性收集了2013年1月至2015年12月在我院开始透析的80岁及以上患者的临床信息。确定死亡率、住院时间和死亡地点以评估患者的生活质量。
共纳入56例患者（14例PD和42例HD）。研究对象的平均年龄为85.2±4.0岁。与家人同住或有专业护理人员在日常生活中提供帮助的PD患者比例高于HD患者（分别为100%和76.2%；p = 0.044）。PD患者的死亡率高于HD患者（p = 0.003），但仅在HD患者中观察到超过180天的长期住院情况（PD与HD：0.0%与16.7%；p = 0.102）。在Barthel指数评分<100的患者中，长期住院差异具有统计学意义（PD与HD：0.0%与30.4%；p = 0.040）。值得注意的是，7例死亡的PD患者中有6例和10例死亡的HD患者中有1例在家中死亡（p = 0.002）。
PD是老年患者理想的居家护理治疗方式，但应考虑护理人员的负担。
