Peritoneal dialysis in the nineth decade of life experience in a single center

Abstract

The clinical outcome of 21 patients on CAPD who were older than 79 years at the time of beginning dialysis is reported in the present paper. These patients represented 5% of 420 patients who were admitted to the CAPD program of our Unit between 1980 and 1995. Fifteen of the patients were men and 6 women, with a mean age of 81 ± 3 years. The median patient survival was 21 months, after 3 years patient survival rate was 30%. The causes of death were cardiovascular (7), cachexia (4), peritonitis (1), liver failure (1) and withdrawal of dialysis (2). The peritonitis rate was 0.6 episodes/year, 45% of episodes were caused by gram + bacteria, 23% by gram - bacteria and in the other episodes peritoneal fluid culture was not performed or no growth was observed. Exit site infection rate was 1 episode every 32 months. Three peritoneal catheters were removed after 1, 14, and 23 months. Most severe complications were dementia (5) and depression (4), severe peripheral vascular disease with pain and ulcers in 3 cases. Quality of life was poor in 4/11 patients surviving after one year. Sixteen patients required a partner for performing the exchanges and many of them needed frequent hospitalization or equivalent care at home.