Suh H, Wadhwa N K, Cabralda T, Sokunbi D, Solomon M
Department of Medicine, State University of New York at Stony Brook.
Adv Perit Dial. 1993;9:134-7.
This study was designed to investigate the outcome of all elderly patients older than 65 who started peritoneal dialysis (PD) between January 1989 and December 1992. One hundred and twenty end-stage renal disease (ESRD) patients commenced PD at our institution between January 1989 and December 1992. All the patients who started, completed PD training, and remained on PD for more than one month were included in the study. Of these, 30 patients were elderly (more than 65 years old) with a mean age of 72 years (range 66-81 years). The total number of patient-months observed was 2035, of which the elderly represented 454 patient-months. Twenty-five percent (30 of 120 patients) were elderly. The causes of ESRD were diabetes mellitus in 6 patients (20%), glomerulonephritis in 6 (20%), atheroembolic disease in 4 (13.3%), hypertension in 2 (6.7%), and unknown etiology in 10 (33.3%) patients. Sixteen patients performed continuous ambulatory peritoneal dialysis (CAPD) and 14 patients continuous cycling peritoneal dialysis (CCPD). Five patients required private home nurses for multiple medical problems and for PD. Mean duration of peritoneal dialysis per patient was 15 months. Four patients were transferred to incenter hemodialysis, one each because of failure to thrive, insurance, catheter malfunction, and fungal peritonitis. One patient recovered renal function after 22 months of PD. Twenty-one episodes of peritonitis occurred over 454 patient-months (1 episode/22 patient-months). In conclusion, the elderly patients on PD have a favorable outcome even with multiple comorbid conditions.
本研究旨在调查1989年1月至1992年12月期间开始进行腹膜透析(PD)的所有65岁以上老年患者的预后情况。1989年1月至1992年12月期间,有120例终末期肾病(ESRD)患者在本机构开始进行PD治疗。所有开始、完成PD培训并持续接受PD治疗超过1个月的患者均纳入本研究。其中,30例患者为老年人(年龄超过65岁),平均年龄为72岁(范围66 - 81岁)。观察到的患者月数总计为2035个,其中老年人占454个患者月。25%(120例患者中的30例)为老年人。ESRD的病因包括:6例(20%)为糖尿病,6例(20%)为肾小球肾炎,4例(13.3%)为动脉粥样硬化栓塞性疾病,2例(6.7%)为高血压,10例(33.3%)病因不明。16例患者进行持续性非卧床腹膜透析(CAPD),14例患者进行持续循环腹膜透析(CCPD)。5例患者因多种医疗问题和PD治疗需要私人家庭护士。每位患者腹膜透析的平均持续时间为15个月。4例患者转为中心血液透析,原因分别是发育不良、保险问题、导管故障和真菌性腹膜炎。1例患者在PD治疗22个月后肾功能恢复。在454个患者月期间发生了21次腹膜炎发作(1次发作/22个患者月)。总之,即使存在多种合并症,接受PD治疗的老年患者仍有良好的预后。