Study of Survival and its Predictors in Elderly Patients on Continuous Ambulatory Peritoneal Dialysis: Single Center Experience

Prit Pal Singh; Harsh Vardhan; Amit Gupta; Amresh Krishna; R K Sharma; Narayan Prasad

Volume : IX, Issue : I, January - 2020

Study of Survival and its Predictors in Elderly Patients on Continuous Ambulatory Peritoneal Dialysis: Single Center Experience

Prit Pal Singh, Harsh Vardhan, Amit Gupta, Amresh Krishna, R K Sharma, Narayan Prasad

Abstract :

Introduction: In last two to three decades, the prevalence of chronic kidney disease (CKD) has shown rising trend globally.With increasing life expectancy and affordability more elderly people are opting for renal replacement therapy.Peritoneal dialysis (PD) remains a good option for renal replacement therapy (RRT) in elderly population as well both in terms of survival and quality of life. Material & method:Retrospective observational study in a tertiary care institutebetween period of 1st January 2009 and 31 December 2013. 44 patients aged more than 65 years of age were evaluated for their PD outcomes. Result: 43 patients were on continuous ambulatory peritoneal dialysis (CAPD) and only one patient was on automated peritoneal dialysis (APD). There were 31 male and 13 female patients. Mean age of the patients was 69.55 years. Mean follow up period was 21.9 month. During follow up period, 25 patients died. Major cause of death was cardiovascular (13patients) followed by peritonitis(5patients). At 1 year and 2 year, Technique survival was 83.5% and 43.7%, and peritonitis free survival was 85% and 43% respectively. Peritonitis occurred in nine patients of which culture was positive in five patients. Mean age of the patients having peritonitis was 68years. Outcome was death in five patients, catheter removal in three patients and complete recovery in two patients.Major cause of death was cardiovascular (13pts) followed by peritonitis(5pts).On univariateanalysis , significant predictors of death were presence of CAD , residual renal function, serum calcium, serum sodium, and serum vitamin D level. Afterthe multivariate analysis and independent t test, CAD, serum sodium, and serum vitamin D level were found to be significantly correlated with the outcome. Conclusion:Our study has shown that peritoneal dialysis is an effective option for elderly population. Patient survival in these elderly patients on PD is as good as in age matched hemodialysis population.Cardiovascular disease was the most common cause of mortality. Rate of peritonitis was higher in our study and was associated with high incidence of death. Technique survival (death censored or non– censored) was comparable to other studies on elderly PD.