213 Elderly Uremic Patients over 75 Years of Age Treated with Long Term Peritoneal Dialysis: A French Multicenter Study

Abstract

We report our experience in 213 elderly patients over 75 years treated by peritoneal dialysis (PC) as first and exclusive dialysis therapy. The mean age at start of PC was 79.4t3.6 years, and the cumulative time on PC was 4551 months (mean time: 21.4 %19.8 months). Twenty-six patients lived in institutions and 187 1ived at home. Thirty patients had an effective autonomy with the ability to carry on normal activities. One hundred and two patients were cared for by a private nurse at home, and 46 patients were cared for in a family environment. Most cases were treated by three exchanges per day (152 cases) and used a nondisconnect system (175 cases) on account of absence of autonomy. The rate of peritonitis per patient month was one episode per 16.8 patient-months. Patient survival (Kaplan-Meier curves) was 74%,59%,45%, and 19% at one, two, three, and five years, respectively. The causes of death were various with a higher frequency of cardiovascular causes (48.3% of the 116 deaths). Thirtythree patients died in less than six months including 18 patients in less than three months. In conclusion: elderly uremic patients can be treated with long-term PC with relatively good results. Mortality is high but essentially due to age and poor general status -the dedication of private home nursing is very important in treating elderly PC patients. This fact often is a necessary condition in maintaining these elderly patients at home.