Abstract :
As the world’s population continues to age, practitioners encounter increasing numbers
of older patients with end-stage renal disease (ESRD) who require renal replacement
therapy (RRT). Conservative management may be considered in older patients and has
been shown to offer comparable survival rates and hospital-free days to RRT patients. At
present, for those who choose RRT, hemodialysis is the most commonly used modality.
Many practitioners believe that peritoneal dialysis (PD), including assisted peritoneal
dialysis, can be used safely in this population. Age is not a contra-indication to peritoneal
dialysis, and a choice of modality should be offered to older patients. Assisted peritoneal
dialysis has been used successfully in multiple regions without an increase in complication
rates. Quality of life is an important issue for older patients with ESRD, and studies
such as Broadening options for long-term Dialysis in the Elderly support the use of PD
in older patients as it is associated with fewer fluctuations in symptoms of ESRD and less
intrusion into people’s lives. This review discusses the appropriateness of initiating RRT
in older patients, choices of modality, underutilization of PD in older patients, use of
assisted PD, complication rates, and quality of life in these patients. overall, PD seems to
be a safe and effective modality of RRT in older patients, and assisted PD can be used in
patients with limited functional impairment.
