Abstract
Twenty-one elderly patients with end-stage renal disease (ESRD) secondary to various etiologies received IPD at our unit. It was done manually by trained staff nurses. Each patient received 20-24 one hour exchanges of 2 liters PD solution twice a week through a permanent Tenckhoff catheter. Mean age of patients was 63 years (range 60–96),12 were male and 9 female. Mean duration of stay on IPD was 23 months (range 18–41). The etiologies of ESRD were: diabetes mellitus (9 patients), unknown etiology (7), hypertension (3), glomerulonephritis and liver cirrhosis (hepatitis C) (2). The peritonitis rate was one episode per 16.3 patient/month. The causative organisms were staphylococcus, coliforms, acinobacter and pseudomonas. Six patients died due to each of the following: 2 septicemia not related to PD; 2 hepatic failure; 2 massive myocardial infarction. Two patients were changed to hemodialysis due to recurrent peritonitis. We observed 7 episodes of catheter exit-site infection; causative organisms were staphylococcus (4), and pseudomonas (3). Staphylococcus cases of exit-site infection responded to local fucidin ointment and oral antibiotic, while in the pseudomonas cases the catheter had to be removed. All patients received erythropoietin and have maintained good hemoglobin levels (10.1 ± 1.2 gm%). They also had adequate control of their serum creatinine and urea level. As the patients improved, they became less dependent on their relatives.
We conclude that IPD is relatively safe and acceptable modality of dialysis treatment in elderly.
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References
Nolph KD. Continuous ambulatory peritoneal dialysis as long-term treatment for End-Stage Renal Disease. Am J Kid Dis 1991; 17: 154–157.
Henrich, WL. Dialysis considerations in the elderly patient. Am J Kid Dis 1990; 16: 339–341.
Ismail N, Hakim RM, Oreopoulos DG, Patrikarea A. Renal replacement therapies in the elderly. Haemodialysis and chronic peritoneal dialysis. Am J Kid Dis 1993; 22: 759–782.
Nissenson AR, Diaz-Buxo JA, Adcock A, Nelms M. Peritoneal dialysis in the geriatric patient. Am J Kid Dis 1990; 16: 335–338.
Matter, WD, McGa Chaie WC, Rigby RJ et al. Selection of ESRD treatment: An international study. Am J Kid Dis 1989; 13: 457–464.
US Renal Data System. 1991 Annual Data Report. Bethesda, MD. The National Institutes of Health, National Institutes of Diabetes and Digestive and Kidney Diseases, 1991 excerpts in Am J Kid Dis 1991; (suppl 2)18: 38–48
Saudi Centre for Organ Transplantation Data, October 1994. Saudi Journal of Kidney Diseases and Transplantation 1994; 5: 500–509.
Benevent D, Benzakour M, Peyronnet P, Legardec, Leroux-Robert C, Charmes JP. Comparison of continuous ambulatory peritoneal dialysis and Haemodialysis in the elderly. Adv Perit Dial 1990; (suppl)6: 68–71.
Gentile DE and The Geriatric Advisory Committee. Peritoneal dialysis in geriatric patients: A survey of clinical practice. Adv Perit Dial 1990; (suppl 6)6: 29–30.
O'Brien M, Zimmerman S: Comparison of peritoneal and hemodialysis in the elderly. Adv Perit Dial 1990; (suppl)6: 65–67.
Nolph KD, Lindblad AS, Novak JW, Steinberg SM: Experiences with the elderly in the National CAPD Registry. Adv Perit Dial 1990; (suppl)6: 33–38.
Oreine R, Einar S, Iversen BM: CAPD in patients above 70 years of age. Adv Perit Dial 1991; 7: 73–76.
Rosansky SJ, Eggers PW: Trends in the US end-stage renal disease population, 1973–1983. Am J Kid Dis 1987; 9: 91–97.
Rubin J, Suh II, Bower J. Survival on dialysis therapy: One center's experience. Am J Med Sci 1989; 297: 80–90.
Suh H, Wadhwa NK, Cabralda T, Sokunbi D, Solomon M. Peritoneal dialysis in elderly end-stage renal disease patients. Adv Perit Dial 1993; 9: 134–137.
McKcvitt PM, Jones JF, Lane DA, Marion RR. The elderly on dialysis: some considerations in compliance. Am J Kid Dis 1990, 16: 346–350.
Sandroni S, Arora N, Vidrine L, Moles K. Feasibility of in-centre staff assisted cycler dialysis. Adv Perit Dial 1990; 6: 76–78.
Benevent D, Benzakour M, Peyronnet P, Legarde C, Leoun-Robert C, Charmes JP. Comparison of continuous ambulatory peritoneal dialysis and haemodialysis in the elderly. Adv Perit Dial 1990; (suppl)6: 68–71.
Nolph KD, Lindblad AS, Novak JW, Steinburg SM. Experiences with the elderly in the National CAPD registry. Adv Perit Dial 1990; (suppl)6: 33–38.
Saklayen MG. CAPD peritonitis-incidence, pathogens, diagnosis and management. Med Cl in North Am. 1990; 74: 997–1010.
Husebye DG, Kjellstrand CM. Old patients and uremia: Rates of acceptance to and withdrawal from dialysis. Int J Artif Organs 1987; 10: 166–172.
Neu S, Kjellstrand CM. Stopping long-term dialysis. An empirical study of withdrawal of life-supporting treatment. N Eng J Med 1986; 314: 14–20.
Port FK. Death and survival in patients with end-stage renal failure. Am J Kid Dis 1990; 15: 215–217.
Kjellstrand CM. Giving life-giving death: Ethical problems of high-technology medicine. Acta Med Scand 1988; (suppl)725: 1–88.
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Mitwalli, A., Malik, G., Al Wakeel, J. et al. Intermittent peritoneal dialysis (IPD) in the elderly. Geriatric Nephrol Urol 6, 21–25 (1996). https://doi.org/10.1007/BF00451973
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DOI: https://doi.org/10.1007/BF00451973