Department of Medicine and Therapeutics, Carol and Richard Yu Peritoneal Dialysis Research Centre, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China.
Perit Dial Int. 2020 Jan;40(1):34-40. doi: 10.1177/0896860819879873.
There is an increasing number of elderly patients on continuous ambulatory peritoneal dialysis (CAPD) who could not perform dialysis exchange themselves and require assistance. We examine the outcome of Chinese CAPD patients who required helper-assisted dialysis and compare the outcome between different types of helper.
We reviewed 133 incident patients on helper-assisted CAPD and 266 incident patients who performed self-CAPD exchanges (self-peritoneal dialysis (PD) group). Outcome measures included patient survival, peritonitis-free survival, and overall peritonitis rate.
At 24 months, patient survival of the helper-assisted and self-PD groups were 56.0% and 80.6%, respectively ( < 0.0001). Within the helper-assisted group, patient survival at 24 months was 55.5%, 63.2%, and 27.2% for the patients with domestic helper, family member, and nursing home staff as their helpers, respectively ( = 0.037). Peritonitis-free survival of the helper-assisted and self-PD groups were 54.2% and 64.9%, respectively ( = 0.039). Within the helper-assisted group, peritonitis-free survival at 24 months was 59.4%, 55.4%, and 37.2% for the patients with domestic helper, family member, and nursing home staff as their helpers, respectively ( = 0.06). There was no significant difference in peritonitis rate between patients with domestic helper, family member, and nursing home staff as their helpers (0.54, 0.57, and 0.94 episodes per patient-year, respectively, = 0.2).
Helper-assisted CAPD patients had worse patient survival and peritonitis-free survival than the self-PD group. Assistance by nursing home staff was associated with worse patients' survival and peritonitis-free survival than assistance by family members or domestic maids.
越来越多的接受持续性不卧床腹膜透析（CAPD）的老年患者无法自行进行透析交换，需要他人协助。我们研究了需要助手协助进行 CAPD 的中国 CAPD 患者的结局，并比较了不同类型助手之间的结局。
我们回顾性分析了 133 例接受助手协助 CAPD 的新发病例患者和 266 例自行 CAPD 交换（自我腹膜透析（PD）组）的新发病例患者。结局指标包括患者生存率、腹膜炎无生存率和总体腹膜炎发生率。
在 24 个月时，助手协助组和自我 PD 组的患者生存率分别为 56.0%和 80.6%（<0.0001）。在助手协助组中，24 个月时患者生存率分别为 55.5%、63.2%和 27.2%，助手分别为家庭佣工、家庭成员和养老院工作人员（=0.037）。助手协助组和自我 PD 组的腹膜炎无生存率分别为 54.2%和 64.9%（=0.039）。在助手协助组中，24 个月时腹膜炎无生存率分别为 59.4%、55.4%和 37.2%，助手分别为家庭佣工、家庭成员和养老院工作人员（=0.06）。家庭佣工、家庭成员和养老院工作人员作为助手的患者腹膜炎发生率无显著差异（分别为 0.54、0.57 和 0.94 例/患者年，=0.2）。
助手协助 CAPD 患者的患者生存率和腹膜炎无生存率均低于自我 PD 组。养老院工作人员的协助与较差的患者生存率和腹膜炎无生存率相关，而家庭成员或家庭佣工的协助则没有显著差异。
