Application of peritoneal dialysis in elderly patients by classifying the age into young-old, old, and oldest-old

Makoto Hiramatsu, Mari Ishida, Yukio Tonozuka, Hiroko Mikami, Toshio Yamanari, Noriya Momoki, Akifumi Onishi, Keisuke Maruyama

Research output: Chapter in Book/Report/Conference proceedingChapter

9 Citations (Scopus)

Abstract

Background: A greater number of end-stage renal disease patients are receiving peritoneal dialysis (PD) or hemodialysis (HD) in Japan. However, medical concerns with advancing age have been raised in PD utilization for elderly patients. The objective of this study was to address the indications for PD in elderly patients in terms of medical concerns such as nutrition state, residual renal function, dialysis efficiency, peritonitis, cardiovascular disease (CVD) complications, and technique survival. Methods: In a retrospective, two-center study, we evaluated 247 patients who newly started PD from 2002 to 2008. All patients were divided into four groups: young (2-microglobulin, cardio-thoracic ratio, 24-hour urine collection and spent dialysate volume was collected at the initiation of PD and after 1, 2, 3, and 4 years. PD withdrawal, occurrence of CVD complications, peritonitis and death were recorded. Results: Nephrosclerosis as a primary disease increased with advancing age (p = 0.001). At baseline, gender, body weight, serum creatinine, hemoglobin and cardio-thoracic ratio were significantly different among the four groups. No significant decrease was shown in urine output with advancing age. The spent dialysate volume was significantly lower (mean 3.8 liters/day) in the oldest-old group compared with the other groups (p = 0.001). However, a smaller volume of PD fluid in the oldestold group was not accompanied by a significantly higher serum ß2-microgloblin level compared with the other groups and there was no reason of PD withdrawal for underdialysis in the old and oldest-old groups. Neither the incidence of CVD complications nor that of peritonitis was increased with advancing age. There was no significant difference in technique survival rate excluding death between each group. These findings suggest that there are no medical concerns to avoid PD therapy in elderly end-stage renal disease patients.

Original languageEnglish
Title of host publicationHome Dialysis in Japan: Contemporary Status
PublisherS. Karger AG
Pages48-56
Number of pages9
Volume177
ISBN (Electronic)9783318021103
ISBN (Print)9783318021097
DOIs
Publication statusPublished - May 11 2012

Fingerprint

Peritoneal Dialysis
Peritonitis
Cardiovascular Diseases
Dialysis Solutions
Chronic Kidney Failure
Renal Dialysis
Thorax
Nephrosclerosis
Urine Specimen Collection
Ascitic Fluid
Serum
Creatinine
Japan
Hemoglobins
Survival Rate
Body Weight
Urine
Survival
Incidence

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Hiramatsu, M., Ishida, M., Tonozuka, Y., Mikami, H., Yamanari, T., Momoki, N., ... Maruyama, K. (2012). Application of peritoneal dialysis in elderly patients by classifying the age into young-old, old, and oldest-old. In Home Dialysis in Japan: Contemporary Status (Vol. 177, pp. 48-56). S. Karger AG. https://doi.org/10.1159/000336935

Application of peritoneal dialysis in elderly patients by classifying the age into young-old, old, and oldest-old. / Hiramatsu, Makoto; Ishida, Mari; Tonozuka, Yukio; Mikami, Hiroko; Yamanari, Toshio; Momoki, Noriya; Onishi, Akifumi; Maruyama, Keisuke.

Home Dialysis in Japan: Contemporary Status. Vol. 177 S. Karger AG, 2012. p. 48-56.

Research output: Chapter in Book/Report/Conference proceedingChapter

Hiramatsu, M, Ishida, M, Tonozuka, Y, Mikami, H, Yamanari, T, Momoki, N, Onishi, A & Maruyama, K 2012, Application of peritoneal dialysis in elderly patients by classifying the age into young-old, old, and oldest-old. in Home Dialysis in Japan: Contemporary Status. vol. 177, S. Karger AG, pp. 48-56. https://doi.org/10.1159/000336935
Hiramatsu M, Ishida M, Tonozuka Y, Mikami H, Yamanari T, Momoki N et al. Application of peritoneal dialysis in elderly patients by classifying the age into young-old, old, and oldest-old. In Home Dialysis in Japan: Contemporary Status. Vol. 177. S. Karger AG. 2012. p. 48-56 https://doi.org/10.1159/000336935
Hiramatsu, Makoto ; Ishida, Mari ; Tonozuka, Yukio ; Mikami, Hiroko ; Yamanari, Toshio ; Momoki, Noriya ; Onishi, Akifumi ; Maruyama, Keisuke. / Application of peritoneal dialysis in elderly patients by classifying the age into young-old, old, and oldest-old. Home Dialysis in Japan: Contemporary Status. Vol. 177 S. Karger AG, 2012. pp. 48-56
@inbook{09321317c3eb4cb59a6848057b6efd29,
title = "Application of peritoneal dialysis in elderly patients by classifying the age into young-old, old, and oldest-old",
abstract = "Background: A greater number of end-stage renal disease patients are receiving peritoneal dialysis (PD) or hemodialysis (HD) in Japan. However, medical concerns with advancing age have been raised in PD utilization for elderly patients. The objective of this study was to address the indications for PD in elderly patients in terms of medical concerns such as nutrition state, residual renal function, dialysis efficiency, peritonitis, cardiovascular disease (CVD) complications, and technique survival. Methods: In a retrospective, two-center study, we evaluated 247 patients who newly started PD from 2002 to 2008. All patients were divided into four groups: young (2-microglobulin, cardio-thoracic ratio, 24-hour urine collection and spent dialysate volume was collected at the initiation of PD and after 1, 2, 3, and 4 years. PD withdrawal, occurrence of CVD complications, peritonitis and death were recorded. Results: Nephrosclerosis as a primary disease increased with advancing age (p = 0.001). At baseline, gender, body weight, serum creatinine, hemoglobin and cardio-thoracic ratio were significantly different among the four groups. No significant decrease was shown in urine output with advancing age. The spent dialysate volume was significantly lower (mean 3.8 liters/day) in the oldest-old group compared with the other groups (p = 0.001). However, a smaller volume of PD fluid in the oldestold group was not accompanied by a significantly higher serum {\ss}2-microgloblin level compared with the other groups and there was no reason of PD withdrawal for underdialysis in the old and oldest-old groups. Neither the incidence of CVD complications nor that of peritonitis was increased with advancing age. There was no significant difference in technique survival rate excluding death between each group. These findings suggest that there are no medical concerns to avoid PD therapy in elderly end-stage renal disease patients.",
author = "Makoto Hiramatsu and Mari Ishida and Yukio Tonozuka and Hiroko Mikami and Toshio Yamanari and Noriya Momoki and Akifumi Onishi and Keisuke Maruyama",
year = "2012",
month = "5",
day = "11",
doi = "10.1159/000336935",
language = "English",
isbn = "9783318021097",
volume = "177",
pages = "48--56",
booktitle = "Home Dialysis in Japan: Contemporary Status",
publisher = "S. Karger AG",

}

TY - CHAP

T1 - Application of peritoneal dialysis in elderly patients by classifying the age into young-old, old, and oldest-old

AU - Hiramatsu, Makoto

AU - Ishida, Mari

AU - Tonozuka, Yukio

AU - Mikami, Hiroko

AU - Yamanari, Toshio

AU - Momoki, Noriya

AU - Onishi, Akifumi

AU - Maruyama, Keisuke

PY - 2012/5/11

Y1 - 2012/5/11

N2 - Background: A greater number of end-stage renal disease patients are receiving peritoneal dialysis (PD) or hemodialysis (HD) in Japan. However, medical concerns with advancing age have been raised in PD utilization for elderly patients. The objective of this study was to address the indications for PD in elderly patients in terms of medical concerns such as nutrition state, residual renal function, dialysis efficiency, peritonitis, cardiovascular disease (CVD) complications, and technique survival. Methods: In a retrospective, two-center study, we evaluated 247 patients who newly started PD from 2002 to 2008. All patients were divided into four groups: young (2-microglobulin, cardio-thoracic ratio, 24-hour urine collection and spent dialysate volume was collected at the initiation of PD and after 1, 2, 3, and 4 years. PD withdrawal, occurrence of CVD complications, peritonitis and death were recorded. Results: Nephrosclerosis as a primary disease increased with advancing age (p = 0.001). At baseline, gender, body weight, serum creatinine, hemoglobin and cardio-thoracic ratio were significantly different among the four groups. No significant decrease was shown in urine output with advancing age. The spent dialysate volume was significantly lower (mean 3.8 liters/day) in the oldest-old group compared with the other groups (p = 0.001). However, a smaller volume of PD fluid in the oldestold group was not accompanied by a significantly higher serum ß2-microgloblin level compared with the other groups and there was no reason of PD withdrawal for underdialysis in the old and oldest-old groups. Neither the incidence of CVD complications nor that of peritonitis was increased with advancing age. There was no significant difference in technique survival rate excluding death between each group. These findings suggest that there are no medical concerns to avoid PD therapy in elderly end-stage renal disease patients.

AB - Background: A greater number of end-stage renal disease patients are receiving peritoneal dialysis (PD) or hemodialysis (HD) in Japan. However, medical concerns with advancing age have been raised in PD utilization for elderly patients. The objective of this study was to address the indications for PD in elderly patients in terms of medical concerns such as nutrition state, residual renal function, dialysis efficiency, peritonitis, cardiovascular disease (CVD) complications, and technique survival. Methods: In a retrospective, two-center study, we evaluated 247 patients who newly started PD from 2002 to 2008. All patients were divided into four groups: young (2-microglobulin, cardio-thoracic ratio, 24-hour urine collection and spent dialysate volume was collected at the initiation of PD and after 1, 2, 3, and 4 years. PD withdrawal, occurrence of CVD complications, peritonitis and death were recorded. Results: Nephrosclerosis as a primary disease increased with advancing age (p = 0.001). At baseline, gender, body weight, serum creatinine, hemoglobin and cardio-thoracic ratio were significantly different among the four groups. No significant decrease was shown in urine output with advancing age. The spent dialysate volume was significantly lower (mean 3.8 liters/day) in the oldest-old group compared with the other groups (p = 0.001). However, a smaller volume of PD fluid in the oldestold group was not accompanied by a significantly higher serum ß2-microgloblin level compared with the other groups and there was no reason of PD withdrawal for underdialysis in the old and oldest-old groups. Neither the incidence of CVD complications nor that of peritonitis was increased with advancing age. There was no significant difference in technique survival rate excluding death between each group. These findings suggest that there are no medical concerns to avoid PD therapy in elderly end-stage renal disease patients.

UR - http://www.scopus.com/inward/record.url?scp=84925866056&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84925866056&partnerID=8YFLogxK

U2 - 10.1159/000336935

DO - 10.1159/000336935

M3 - Chapter

SN - 9783318021097

VL - 177

SP - 48

EP - 56

BT - Home Dialysis in Japan: Contemporary Status

PB - S. Karger AG

ER -