Peritoneal Dialysis in Elderly Patients

摘要

Background: Dialysis is now often being initiated in older patients. In Japan, patients are around 69 years of age on initiation of dialysis. The total dialysis population undergoing peritoneal dialysis (PD) stands at just 3% in Japan, a much lower proportion than in other industrialized countries. Under the current policy, there has been a move away from hospital-based care of elderly patients to home-based care. Here, in the context of this change, we describe the experiences of our elderly patients in initiating and maintaining PD, Summary: From 2003 to 2016, a total of 128 ESRD patients started PD therapy at our university hospital. After dividing these patients into two groups, 19 patients who were >70 years of age (elderly group) and 109 patients <70 years of age (non-elderly group), we analyzed patient characteristics, assistance needed to exchange dialysate bags, technical survival, and patient survival. There were no significant differences between the two groups in body mass index, total protein, albumin, estimated glomerular filtration rate, hemoglobin, urinary protein, or urinary volume at initiation of PD. Mean follow-up was similar between the groups. The elderly group did not show inferior technical survival, but patient survival was shorter than in the non-elderly group. Half of the elderly group exchanged PD dialysate by themselves. Key Messages: Although patient survival was shorter in the elderly group, choosing to initiate PD seems to be a good choice even in advanced age when considering the better quality of life afforded by home care.