Af. Devecchi et al., PERITONEAL-DIALYSIS IN NONDIABETIC PATIENTS OLDER THAN 70 YEARS - COMPARISON WITH PATIENTS AGED 40 TO 60 YEARS, American journal of kidney diseases, 31(3), 1998, pp. 479-490
In all industrial countries, the number of elderly patients who need d
ialysis has increased in recent years. In the present study, we retros
pectively analyzed two different age groups of nondiabetic peritoneal
dialysis patients treated at the same unit by the same team of physici
ans and nurses with the same protocols. However, our purpose was to st
udy possible differences in technique and survival rates, causes of dr
opout, complications, hospitalization rate, and everyday needs between
the two groups. The results of 63 consecutive nondiabetic patients ol
der than 70 years treated with continuous ambulatory peritoneal dialys
is (CAPD) were compared with those of 86 nondiabetic patients aged 40
to 60 years treated during the same period. Patient survival was signi
ficantly worse in the elderly patients, but the observed to expected s
urvival ratio with respect to age was similar, Technique survival was
comparable in the two groups, Total hospitalization was 5,501 days (32
d/yr) in the elderly patients and 4,511 days (18 d/yr; P < 0.05) in t
he younger group, The peritonitis rate was 0.52 episodes/patient-year
in the elderly patients and 0.37 episodes/patient-year in the younger
patients (P < 0.002). The exit site infection rate was similar in the
two groups (0.30 episodes/yr v 0.29 episodes/yr). Other complications
related to CAPD did not differ between the elderly and younger patient
s, Rehabilitation and biochemical data after 1 year of CAPD were simil
ar in the two groups of patients, After 1 year of treatment, 12% of th
e younger patients and 43% of the elderly patients (P < 0.005) needed
a partner for dialysis, Twenty-nine of 39 (74%) of the elderly patient
s and 30 of 53 (57%) of the younger patients considered their lifestyl
e acceptable after 1 year of dialysis. Thirty-four of 39 (87%) of the
elderly patients and 32 of 53 (60%) of the younger patients (P < 0.02)
rated their physical and social state after rehabilitation as better
or comparable to that they had before terminal uremia, (C) 1998 by the
National Kidney Foundation, Inc.