Skip to main content
SpringerLink
Log in

Peritoneal dialysis in older individuals

  • Published:
Geriatric Nephrology and Urology

Abstract

Peritoneal dialysis is a viable alternative to hemodialysis for managementof elderly patients requiring renal replacement therapy. Peritoneal dialysisconfers several advantages over hemodialysis for the elderly -- namelyindependence, home treatment and perhaps preservation of residual renal function. Although there are a few contraindications, these are minimaland can largely be overcome with attention to special training and theuse of healthcare partners to perform the technique of peritoneal dialysisexchanges.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Winchester JF, Rakowski TA. End-stage renal disease and its management in the elderly. Clin Geriatric Med 1998; 14: 255.

    Google Scholar 

  2. Mignon F, Michel C, Mentre F, Viron B. Worldwide demographics and future trends of the management of renal failure in the elderly. Kidney Int 1993; 43: 18.

    Google Scholar 

  3. Porush JG, Faubert PF. Chronic renal failure. In: JG Porush, ed. Renal Disease in the Aged. Boston: Little Brown Co, 1991: 285.

    Google Scholar 

  4. Blagg CR. Chronic renal failure in the elderly. In: DG Oreopoulos, ed. Geriatric Nephrology. The Hague, Boston: Martinus Nijhoff, 1986: 117.

    Google Scholar 

  5. Nissenson AR. Peritoneal dialysis in geriatric patients; an overview and introduction. Adv Perit Dial 1990; 6 (suppl): 1.

    Google Scholar 

  6. Geerlings W, Tufveson G, Brunner FP et al. Combined report on regular dialysis and transplantation in Europe XXI 1990. Nephrol Dial Transplant 1990; 6 (suppl. 2): 82.

    Google Scholar 

  7. Ismail N, Hakim RM, Patrikara A, Oreopoulos DG. Renal replacement therapies in the elderly. Am J Kidney Dis 1993; 22: 7591.

    Google Scholar 

  8. US Renal Data System, USRDS 1998 Annual Data Report. Bethesda, MD: NIH, National Institute of Diabetes and Digestive and Kidney Diseases, 1998.

    Google Scholar 

  9. Mignon F, Siohba P, Legalicier B et al. The management of uremia in the elderly: Treatment Choices. Nephrol Dial Transplant 1995; 10: 551.

    Google Scholar 

  10. Williams P. Ruch DR. Geriatric polypharmacy. Hosp Prac 1986; 21: 104.

    Google Scholar 

  11. St Peter WL, Clark JL, Levos OM. Drug therapy in haemodialysis patients. Special considerations in the elderly. Drugs Aging 1998; 6: 441.

    Google Scholar 

  12. Redelmeier DA, Tan SH, Booth GL. The treatment of unrelated medical disorders in patients with chronic unrelated medical diseases. N Engl J Med 1998; 338: 1516.

    Google Scholar 

  13. Zarbock SF. Quality of care for dialysis patients: national initiative focuses on improved treatment. Home Care Provid 1997; 2: 62.

    Google Scholar 

  14. Levin A, Lewis M, Mortiboy P et al. Multidisciplinary predialysis programs: Quantification and limitations of their impact on patient outcomes in two Canadian settings. Am J Kidney Dis 1997; 29: 533.

    Google Scholar 

  15. Obrador GT, Pereira BJ. Early referral to the nephrologist and timely initiation of renal replacement therapy: A paradigm shift in the management of patients with chronic renal failure. Am J Kidney Dis 1998; 31: 398.

    Google Scholar 

  16. Callaghan L, Chu M, Cumings A et al. You can't teach an old dog new tricks. In: DG Oreopoulos, MF Michelis, S. Hershorn, eds. Nephrology and Urology in the Aged Patient. Dordrecht, Boston: Kluwer Academic Publishers, 1993: 317.

    Google Scholar 

  17. Kelman B. Challenges in the training of elderly CAPD patients. In: DG Oreopoulos, MF Michelis, S Hershorn, eds. Nephrology and Urology in the Aged Patient. Dordrecht, Boston: Kluwer Academic Publishers, 1993: 323.

    Google Scholar 

  18. Twardowski ZJ, Prowant BF, Pickett B et al. Four-year experience with swan neck presternal peritoneal dialysis catheter. Am J Kidney Dis 1996; 27: 99.

    Google Scholar 

  19. Woods JD, Turenne MN, Strawderman RL et al. Vascular access survival among incident hemodialysis patients in the United States. Am J Kidney Dis 1997; 30: 50.

    Google Scholar 

  20. Feldman HI, Held PJ, Hutchinson JT et al. Hemodialysis vascular access morbidity in the United States. Kidney Int 1993; 43: 1091.

    Google Scholar 

  21. Beusterien KM, Nissenson AR, Port FK et al. The effects of recombinant human erythropoietin on functional health and well-being in chronic dialysis patients. J Am Soc Nephrol 1996; 7: 763.

    Google Scholar 

  22. US Renal Data System, USRDS 1991 Annual Data Report. Bethesda, MD: NIH, National Institute of Diabetes and Digestive and Kidney Diseases, 1991.

    Google Scholar 

  23. Fischer A, Bock A, Brunner FP. Three consecutive day collection of dialysate and urine to identify non-compliance in CAPD patients. Nephrol Dial Transplant 1997; 12: 570.

    Google Scholar 

  24. Tzamaloukas AH, Braun M, Malhotra D, Murata GH. Estimated versus predicted creatinine generation as an indicator of compliance with the prescribed dose of continuous peritoneal dialysis. Int J Artif Organs 1996; 19: 151.

    Google Scholar 

  25. Lowrie EG, Lew NL. Death risk in hemodialysis patients: The predictive value of commonly measured variables and an evaluation of death rate differences between facilities. Am J Kidney Dis 1990; 15: 458.

    Google Scholar 

  26. Nolph KD, Lindblad AS, Novak JW, Steinberg SM. Experiences with the elderly in the National CAPD Registry. Adv Perit Dial 1990; 6 (suppl): 33.

    Google Scholar 

  27. Holley JL, Bernardini J, Perlmutter JA, Piraino B. A comparison of infection rates among older and younger patients on continuous ambulatory peritoneal dialysis. Perit Dial Int 1994; 14: 77.

    Google Scholar 

  28. Nissenson AR, Gentile DE, Soderblom R. CAPD in the elderly: Southern California/Southern Nevada experience. Adv Perit Dial 1990; 6 (suppl): 51.

    Google Scholar 

  29. Churchill DN, Thorpe KE, Vonesh EF, Keshaviah PR. Lower probability of patient survival with continuous peritoneal dialysis in the United States compared with Canada. Canada-USA (CANUSA) Peritoneal Dialysis Study Group. J Am Soc Nephrol 1997; 8: 965.

    Google Scholar 

  30. Lysaght MJ, Vonesh EF, Gotch F et al. The influence of dialysis treatment modality on the decline of remaining renal function. Trans Am Soc Artif Intern Organs 1991; 37: 598.

    Google Scholar 

  31. NKF-DOQI clinical practice guidelines for peritoneal dialysis adequacy. Am J Kidney Dis 1997; 30(3) (Suppl 2): S67.

  32. Port FK, Bloembergen WE, Erickson R, Held PJ. PD patients have fewer comorbid conditions and better quality of life at baseline. Peritoneal Dialysis Today 1998; 4: 7 (on line journal http//:www.multi-med.com/pdtoday/art0698-7.html).

    Google Scholar 

  33. Redelmeier DA, Tan SH, Booth GL. The treatment of unrelated disorders in patients with chronic medical diseases. N Engl J Med 1998; 338: 1516.

    Google Scholar 

  34. Schleifer CR. Nursing home dialysis: Can we meet the challenge? Perit Dial Int 1997; 17: 234.

    Google Scholar 

  35. Anderson JE, Kraus J, Sturgeon D. Incidence, prevalence, and outcomes of end-stage renal disease patients placed in nursing homes. Am J Kidney Dis 1993; 21: 619.

    Google Scholar 

  36. Anderson JE, Sturgeon D, Lindsay J, Schiller A. Use of continuous ambulatory peritoneal dialysis in a nursing home; patient characteristics, technique success, and survival predictors. Am J Kidney Dis 1990; 16: 137.

    Google Scholar 

  37. Anderson JE. Ten year's experience with CAPD in a nursing home setting. Perit Dial Int 1997; 17: 255.

    Google Scholar 

  38. Rettig RA, Sadler JH, Meyer KB et al. Assessing health and quality of life outcomes in dialysis: A report to the Institute of Medicine workshop. Am J Kidney Dis 1997; 30: 140.

    Google Scholar 

  39. Szabo E, Moody H, Hamilton T et al. Choice of treatment improves quality of life. A study on patients undergoing dialysis. Arch Intern Med 1997; 157: 1352.

    Google Scholar 

  40. Burton HJ, Kline SA, Lindsay RM, Heidenheim AP. The relationship of depression to survival in chronic renal failure. Psychosom Med 1986; 48: 261.

    Google Scholar 

  41. Hofmann JC, Wenger NS, Davis RB et al. Patient preferences for communication with physicians about end-of-life decisions. Ann Intern Med 1997; 127: 1.

    Google Scholar 

  42. Neu S, Kjellstrand CM. Stopping long-term dialysis. An empirical study of withdrawal of life-supporting treatment. N Engl J Med 1986; 314: 14.

    Google Scholar 

  43. Port FK, Wolfe RA, Hawthorne VM et al. Discontinuation of dialysis therapy as a cause of death. Am J Nephrol 1989; 9:145.

    Google Scholar 

  44. McClearn GE, Johansson B, Berg S et al. Substantial genetic influence on cognitive abilities in twins 80 or more years old. Science 1997; 276: 1560.

    Google Scholar 

  45. Kjellstrand CM, Cranford R, Kaye M. Stopping Dialysis. Practice and cultural religious and legal aspects. In: C Jacobs, CM Kjellstrand, KM Koch, JF Winchester, eds. Replacement of Renal Function by Dialysis. Dordrecht, Boston: Kluwer Academc Publishers, 1996: 1480.

    Google Scholar 

  46. De Vecchi AF, Maccario M, Braga M et al. Peritoneal dialysis in nondiabetic patients older than 70 years: Comparison with patients aged 40 to 60 years. Am J Kidney Dis 1998; 3: 479.

    Google Scholar 

  47. Grapsa E, Oreopoulos DG. Dialysis in the elderly. In: C Jacobs, CM Kjellstrand, KM Koch, JF Winchester, eds., Replacement of Renal Function by Dialysis. Dordrecht, Boston: Kluwer Academic Publishers, 1996: 896.

    Google Scholar 

  48. Oreopoulos DG. Dialyzing the elderly. Perit Dial Int 1997; 17 (suppl 2): S7.

    Google Scholar 

  49. Carey H, Finkelstein S, Santacroce S et al. The impact of psychosocial factors and age on CAPD dropout. Adv Perit Dial 1990; 6 (suppl): 26.

    Google Scholar 

  50. Capuano A, Sepe V, Cinafrone P et al. Cardiovascular impairment, dialysis strategy and tolerance in elderly and young patients on maintenance haemodialysis. Nephrol Dial Transplant 1990; 5: 1023.

    Google Scholar 

  51. Gokal R. CAPD in the elderly — European and UK experience. Adv Perit Dial 1990; 6 (suppl): 38.

    Google Scholar 

  52. Dobkin JF, Miller PJ, Hutchinson JT et al. Hemodialysis vascular access morbidity in the United States. Kidney Int 1993; 43: 1091.

    Google Scholar 

  53. Segoloni GP, Salomone M, Piccoli GB. CAPD in the elderly: Italian multicenter experience. Adv Perit Dial 1990; 6 (suppl): 41.

    Google Scholar 

  54. Chester AC, Rakowski TA, Argy WP et al. Hemodialysis in the eighth and ninth decades of life. Arch Intern Med 1979; 139: 1900.

    Google Scholar 

  55. Posen GA, Fenton SSA, Arbus GS et al. The Canadian experience with peritoneal dialysis in the elderly. Adv Perit Dial 1990; 6 (suppl): 47.

    Google Scholar 

  56. US Renal Data System, USRDS 1997 Annual Data Report. Bethesda, MD: NIH, National Institute of Diabetes and Digestive and Kidney Diseases, 1997.

    Google Scholar 

  57. Port FK, Novello AC, Wolfe RA. Outcome of treatment modalities for geriatric end-stage renal disease. In: MF Michelis, BB Davis, HG Preuss, eds. Geriatric Nephrology. New York: Field Rich and Associates, 1986: 149.

    Google Scholar 

  58. Rotellar E, Lubelza RA, Rotellar C et al. Must patients over 65 be hemodialyzed. Nephron 1985; 41: 152.

    Google Scholar 

  59. Disney AP. Dialysis treatment in Australia, 1982–1988. Am J Kidney Dis 1990; 15: 384.

    Google Scholar 

  60. Canadian Organ Replacement Registry: Kidney Foundation of Canada Report, 1989.

  61. Nissenson AR, Gentile DE, Soderblom R. CAPD in the elderly: Southern California/Southern Nevada experience. Adv Perit Dial 1990; 6 (suppl): 51.

    Google Scholar 

  62. Segoloni GP, Salomone M, Piccoli GB. CAPD in the elderly: Italian multicenter study experience. Adv Perit Dial 1990; 6 (suppl): 41.

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Georgetown University Medical Center, Washington, DC, USA

    James F. Winschester

Authors
  1. James F. Winschester
    View author publications

    You can also search for this author in PubMed Google Scholar

Rights and permissions

Reprints and permissions

About this article

Cite this article

Winschester, J.F. Peritoneal dialysis in older individuals. Geriatric Nephrology and Urology 9, 147–152 (1999). https://doi.org/10.1023/A:1008374531974

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1023/A:1008374531974

Search

Navigation