Compared with younger peritoneal dialysis patients, elderly patients have similar peritonitis-free survival and lower risk of technique failure, but higher risk of peritonitis-related mortality

Lim, Wai H., Dogra, Gursharan K., McDonald, Stephen P., Brown, Fiona G. and Johnson, David W. (2011) Compared with younger peritoneal dialysis patients, elderly patients have similar peritonitis-free survival and lower risk of technique failure, but higher risk of peritonitis-related mortality. Peritoneal Dialysis International, 31 6: 663-671. doi:10.3747/pdi.2010.00209


Author Lim, Wai H.
Dogra, Gursharan K.
McDonald, Stephen P.
Brown, Fiona G.
Johnson, David W.
Title Compared with younger peritoneal dialysis patients, elderly patients have similar peritonitis-free survival and lower risk of technique failure, but higher risk of peritonitis-related mortality
Journal name Peritoneal Dialysis International   Check publisher's open access policy
ISSN 0896-8608
Publication date 2011-11
Sub-type Article (original research)
DOI 10.3747/pdi.2010.00209
Open Access Status
Volume 31
Issue 6
Start page 663
End page 671
Total pages 9
Place of publication Milton, ON, Canada
Publisher Multimed
Collection year 2012
Language eng
Formatted abstract
Background: The number of elderly patients with end-stage kidney disease (ESKD) is increasing worldwide, but the proportion of elderly patients commencing peritoneal dialysis (PD) is falling. The reluctance of elderly ESKD patients to consider PD may be related to a perception that PD is associated with greater rates of complications. In the present study, we compared outcomes between younger and older PD patients.
Methods: Using Australia and New Zealand Dialysis Registry data, all adult ESKD patients commencing PD between 1991 and 2007 were categorized into under 50, 50 – 64.9, and 65 years of age or older groups. Time to first peritonitis, death-censored technique failure, and peritonitis-associated and all-cause mortality were evaluated by multivariate Cox proportional hazards model analysis.
Results: Of the 12932 PD patients included in the study, 3370 (26%) were under 50 years of age, 4386 (34%) were 50 – 64.9 years of age, and 5176 (40%) were 65 years of age or older. Compared with younger patients (<50 years), elderly patients (≥65 years) had a similar peritonitis-free survival and a lower risk of death-censored technique failure [hazard ratio (HR): 0.85; 95% confidence interval (CI): 0.79 to 0.93], but they had higher peritonitis-related (HR: 2.31; 95% CI: 1.68 to 3.18) and all-cause mortality (HR: 2.90; 95% CI: 2.60 to 3.23).
Conclusions: Not unexpectedly, elderly patients have higher peritonitis-related and all-cause mortality, which is likely a consequence of a greater prevalence of comorbid disease. However, compared with younger patients, elderly patients have superior technique survival and similar peritonitis-free survival, suggesting that PD is a viable renal replacement therapy in this group of patients.
Keyword Elderly
Peritonitis
Technique survival
Patient survival
Registry
ANZDATA
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: Official 2012 Collection
School of Medicine Publications
 
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