Medical Faculty, Department of Nephrology, Atatürk University, Erzurum, Turkey.
Semin Dial. 2024 Mar-Apr;37(2):153-160. doi: 10.1111/sdi.13180. Epub 2023 Sep 21.
With a global increase in life expectancy around the world, the burden of chronic kidney disease in the elderly is increasing. The number of elderly patients undergoing peritoneal dialysis (PD) is also increasing. There is still a perception that PD may be associated with an increased risk of complications in these elderly patients.
A total of 311 patients, of which 103 PD patients aged 65 and over and 208 PD patients under 65 years of age, were followed in a single center and evaluated, retrospectively. Demographic data of these patients, albumin values at first PD and during PD time, residual urine amount, number of peritonitis, time to the first peritonitis attack, PD endpoints, and mortality were compared.
Peritonitis and technique failure rates were lower in patients aged 65 and over who applied PD (0.61-0.75, 6.8%-23.1%, respectively). There was no difference in peritonitis-free survival (p = 0.931). Need for help HR 2.569 [95%CI 1.564-4.219] (p < 0.05), time to first peritonitis attack HR 0.983 [95%CI 0.974-0.992] (p < 0.05), mean albumin value HR 0.191 [95%CI 0.088-0.413] (p < 0.05), urine output level HR 1.154 [95%CI 1.010-1.318] (p < 0.05) were factors affecting mortality.
Peritonitis and technical survival evaluations of elderly PD patients, other than mortality, were lower than younger PD patients. However, the need for help is one of the biggest obstacles to this method for the elderly. We believe that incentives in this regard will increase the number of elderly PD patients.
随着全球预期寿命的增加,老年人群中慢性肾脏病的负担也在增加。接受腹膜透析 (PD) 的老年患者人数也在增加。人们仍然认为 PD 可能与这些老年患者的并发症风险增加有关。
在单中心回顾性评估了 311 名患者,其中 103 名 PD 患者年龄在 65 岁及以上,208 名 PD 患者年龄在 65 岁以下。比较了这些患者的人口统计学数据、首次 PD 时和 PD 期间的白蛋白值、残余尿量、腹膜炎次数、首次腹膜炎发作时间、PD 终点和死亡率。
应用 PD 的 65 岁及以上患者的腹膜炎和技术失败率较低(分别为 0.61-0.75%和 6.8%-23.1%)。无腹膜炎无生存差异(p=0.931)。需要帮助的 HR 为 2.569 [95%CI 1.564-4.219](p<0.05),首次腹膜炎发作时间的 HR 为 0.983 [95%CI 0.974-0.992](p<0.05),平均白蛋白值的 HR 为 0.191 [95%CI 0.088-0.413](p<0.05),尿量水平的 HR 为 1.154 [95%CI 1.010-1.318](p<0.05)是影响死亡率的因素。
除死亡率外,老年 PD 患者的腹膜炎和技术生存评估均低于年轻 PD 患者。然而,对老年人来说,需要帮助是采用这种方法的最大障碍之一。我们相信,在这方面的激励措施将增加老年 PD 患者的数量。