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Possible factors contributing to similar peritoneal dialysis outcome in patients over 60 years of age and the younger ones

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Abstract

The aim of studies was a comparison of dialysisadequacy, nutritional parameters, results ofthe peritoneal equilibration test (PET) andselected standard clinical and laboratory datain peritoneal dialysis (PD) patients withdifferent age, but comparable PD duration andoutcome. Two groups of patients were examined:group I (n = 21, 9 F, 12 M) – age 67.7 ±4.5 yrs, PD duration 20.1 ± 12.1 months;group II (n = 21, 9 F, 12 M) – age 42.8 ±9.1 yrs, PD duration 20.7 ± 12.1 months.Parameters of PD adequacy, results of PET,markers of nutrition and standard laboratorymeasures were determined every 3 months to theend of PD treatment. First obtained values,mean values representing the entire PD courseand last values obtained before the end of PDtherapy were compared in group I and II.Differences in results obtained at thebeginning and at the end of PD therapy werealso compared in each group. At the beginningof PD therapy the older patients showed highertotal fat mass (TFM) expressed as % of totalbody mass (TBM), lower lean body mass (LBM),lower serum levels of iron, phosphorus andcreatinine as well as lower transferrinsaturation. When mean values representing theentire PD course were compared, the olderpatients showed higher TFM as % of TBM andserum ferritin level, whereas lower values wereobserved for diastolic blood pressure (DBP),LBM, serum creatinine, phosphorus and iron. Atthe end of PD therapy TFM as % of TBM and serumferritin level remained higher in olderpatients as well as lower both DBP and LBM weremaintained. Additionally, serum cholesterollevel and residual renal function (RRF) becameat the end of PD treatment higher in the olderindividuals compared to the younger ones. Thedifference in RRF between the two groups wascaused by the decline in RRF in the youngerpatients with relatively stable values of RRFin the older ones. Nutritional parametersimproved in the course of PD only in theyounger group. In conclusion, the olderpatients reach similar PD outcome parameterscompared to the younger ones while they showhigher TFM as % of TBM, stable RRF and moresatisfactory DBP. However, elderly patientsshow a greater progress in the deterioration ofindices of both inflammation andatherosclerosis and therefore are not able toimprove nutritional parameters.

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Authors and Affiliations

  1. Chair and Department of Nephrology, Transplantology and Internal Diseases, Karol Marcinkowski University of Medical Sciences, Poznañ, Poland

    Alicja E. Grzegorzewska & Magdalena Leander

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  1. Alicja E. Grzegorzewska
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  2. Magdalena Leander
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Grzegorzewska, A.E., Leander, M. Possible factors contributing to similar peritoneal dialysis outcome in patients over 60 years of age and the younger ones. Int Urol Nephrol 34, 565–572 (2002). https://doi.org/10.1023/A:1025601229916

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