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Peritoneal Dialysis in the Elderly Patient

  • Clare B. Jones
  • Joanne M. BargmanEmail author
Chapter

Abstract

In most countries, elderly patients who commence renal replacement therapy (RRT) are more likely to be started on hemodialysis (HD) rather than peritoneal dialysis (PD) despite comparable medical outcomes between the two modalities. In this chapter, we explore the potential benefits of PD for older patients, including the maintenance of independence and treatment flexibility. Additionally, medical benefits of PD such as markedly reduced myocardial stunning and the absence of the need for vascular access are discussed.

We also investigate the barriers to PD use in this population and how they can be overcome. Many countries now utilize the concept of assisted PD in order to provide support for patients at home.

The complications of PD are clearly relevant in the elderly population. Peritonitis appears to result in higher mortality in the elderly compared to younger patients. However, exit site infections may be less prevalent.

Treating older patients can be complex; particularly when aiming to balance appropriate medical management with individual goals of care. Bearing this in mind, the PD prescription can be easily tailored to suit a particular patient’s needs. It is also important that physicians looking after the elderly patient are familiar with palliative care options and resources.

Keywords

Elderly patients Renal Replacement Therapy (RRT) Hemodialysis (HD) Peritoneal Dialysis (PD) Assisted PD Peritonitis Nutrition Quality of life Palliative care 

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Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  1. 1.University Health Network and University of TorontoTorontoCanada

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