Chronic peritoneal dialysis in octogenarians

Background. During the past few decades the pattern of end-stage renal fail ure disease has changed with increasing number of elderly patients admitted for dialysis. In spite of their increasing number, little is known about t he optimal mode of therapy of the 'old old' (those greater than or equal to 80 years) patients. Methods. In this retrospective study, we analysed the results of treatment of 31 non-institutionalized 'old old' patients at Toronto Western Hospital (17) and Scarborough General Hospital (14) and seven institutionalized. pat ients in chronic care. Riverdale Hospital. The patients were on CAPD with T win-bag Baxter (28) or Home Choice, Baxter or Fresenius CCPD system (10). P atients were screened at the CAPD clinic when routine blood investigations were done. Patient and technique survival. initial and final laboratory dat a (last visit or before death) and complications related unrelated to dialy sis method are presented. Results. Multiple comorbid conditions were present at the start of the trea tment and new added during treatment: very few were dialysis-related. The m ajority of non-institutionalized patients required assistance of home-care nurse to perform dialysis. Peritonitis ( 1/28.6 patient months) and exit-si te infection rate (1/75.1 patient months) were low and responded to treatme nt. Incidence of peritonitis was higher among institutionalized debilitated patients (1/5.3 patient months). Incidence of hospitalization was 1/14.7 p atient months and patients spent in hospital 7.5 days patient year. Forty-s even per cent of patients survived 24 months, 39% survived 30 months. Techn ique survival was 91.5% at 12 months and 81.4% at 30 months. Poor appetite and malnutrition were frequent among very old patients. Patients and their families were motivated for treatment and discontinuation of dialysis was n ot higher than described elsewhere in literature. Conclusions. This study has demonstrated that chronic peritoneal dialysis c ould be recommended as a safe and suitable modality or treatment of end-sta ge renal failure in old old patients.