Giuliani Anna, Karopadi Akash Nayak, Prieto-Velasco Mario, Manani Sabrina Milan, Crepaldi Carlo, Ronco Claudio
Department of Nephrology, Dialysis and Transplantation, International Renal Research Institute of Vicenza (IRRIV), San Bortolo Hospital, Vicenza, Italy
Dr. Nayak Dialysis Centres Private Limited, Somajiguda, Hyderabad, Telangana, India.
Perit Dial Int. 2017 Sep-Oct;37(5):503-508. doi: 10.3747/pdi.2016.00214.
End-stage renal disease (ESRD) is common in the elderly population, and renal replacement therapy (RRT) is often required. However, in this particular subgroup of patients, the choice between hemodialysis (HD) and peritoneal dialysis (PD) is often not an easy decision to make. Published literature has adequately demonstrated that PD prevalence is significantly less than HD across all patient age groups despite several advantages. We also know that elderly patients are less likely to complete a PD assessment, due to both medical and social barriers. Additionally, elderly patients are often reluctant to go ahead with PD despite being eligible PD candidates, mainly due to the fear of performing self-therapy. Recently, many new assisted PD (asPD) programs have cropped up in several countries. The main aim of these programs is to overcome barriers to PD and to promote PD utilization among elderly and non-self-sufficient patients. Although asPD has proven to be associated with good clinical results, there still remain concerns about its greater use. In this review, we will first describe an ideal asPD model and then enumerate examples of strategies and outcomes associated with successful asPD programs worldwide.
终末期肾病（ESRD）在老年人群中很常见，通常需要进行肾脏替代治疗（RRT）。然而，在这一特定患者亚组中，血液透析（HD）和腹膜透析（PD）之间的选择往往并非易事。已发表的文献充分表明，尽管腹膜透析有诸多优势，但在所有患者年龄组中，其普及率明显低于血液透析。我们也知道，由于医疗和社会障碍，老年患者完成腹膜透析评估的可能性较小。此外，老年患者尽管符合腹膜透析条件，但往往因害怕进行自我治疗而不愿接受腹膜透析。最近，几个国家出现了许多新的辅助腹膜透析（asPD）项目。这些项目的主要目的是克服腹膜透析的障碍，促进老年和非自理患者对腹膜透析的使用。尽管辅助腹膜透析已被证明与良好的临床效果相关，但人们对其更多应用仍存在担忧。在本综述中，我们将首先描述理想的辅助腹膜透析模式，然后列举全球范围内成功的辅助腹膜透析项目的策略和成果实例。
