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Elderly peritoneal dialysis compared with elderly hemodialysis patients and younger peritoneal dialysis patients: Competing risk analysis of a Korean prospective cohort study

  • CRC for ESRD Investigators
  • Seoul National University
  • SMG-SNU Seoul Boramae Medical Center
  • Clinical Research Center for End Stage Renal Disease
  • Eulji University
  • Kyungpook National University
  • Gyeongsang National University
  • Yeungnam University
  • Pusan National University
  • Dong-A University
  • Daegu Fatima Hospital
  • Inje University
  • University of Ulsan
  • Gachon University
  • Yonsei University
  • National Health Insurance Corporation Ilsan Hospital
  • Ewha Womans University
  • Myongji Hospital
  • The Catholic University of Korea
  • Chung-Ang University
  • Chungbuk National University
  • Chungnam National University
  • Cheju Halla General Hospital

Research output: Contribution to journalJournal articlepeer-review

Abstract

The outcomes of peritoneal dialysis (PD) in elderly patients have not been thoroughly investigated. We aimed to investigate the clinical outcomes and risk factors associated with PD in elderly patients. We conducted a prospective observational nationwide adult end-stage renal disease (ESRD) cohort study in Korea from August 2008 to March 2013. Among incident patients (n = 830), patient and technical survival rate, quality of life, and Beck's Depression Inventory (BDI) scores of elderly PD patients (≥65 years, n = 95) were compared with those of PD patients aged ≤49 years (n = 205) and 50∼64 years (n = 192); and elderly hemodialysis (HD) patients (n = 315). The patient death and technical failure were analyzed by cumulative incidence function. Competing risk regressions were used to assess the risk factors for survival. The patient survival rate of elderly PD patients was inferior to that of younger PD patients (P<0.001). However, the technical survival rate was similar (P = 0.097). Compared with elderly HD patients, the patient survival rate did not differ according to dialysis modality (P = 0.987). Elderly PD patients showed significant improvement in the BDI scores, as compared with the PD patients aged ≤49 years (P = 0.003). Low albumin, diabetes and low residual renal function were significant risk factors for the PD patient survival; and peritonitis was a significant risk factor for technical survival. Furthermore, low albumin and hospitalization were significant risk factors of patient survival among the elderly. The overall outcomes were similar between elderly PD and HD patients. PD showed the benefit in BDI and quality of life in the elderly. Additionally, the technical survival rate of elderly PD patients was similar to that of younger PD patients. Taken together, PD may be a comparable modality for elderly ESRD patients.

Original languageEnglish
Article numbere0131393
JournalPLoS ONE
Volume10
Issue number6
DOIs
StatePublished - 2015.06.29

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

  1. SDG 3 - Good Health and Well-being
    SDG 3 Good Health and Well-being

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