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Abstract: FR-PO660

Peritoneal Dialysis in the Elderly: An Opportunity Not to Miss

Session Information

Category: Dialysis

  • 703 Dialysis: Peritoneal Dialysis

Authors

  • Ohman, Jakob David, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, United States
  • Gama, Vivian, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, United States
  • Singh, Tripti, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, United States
  • Astor, Brad C., University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, United States
  • Waheed, Sana, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, United States
Background

End Stage Renal Disease (ESRD) prevalence is steadily increasing in the United States with 700,000 patients currently requiring some form of renal replacement therapy, with a steeper increase in prevalence in the older population (age > 65 years). The rate of peritoneal dialysis (PD) utilization in the US is low at 7% of the ESRD population. The aim of this study is to find the rate of utilization of PD in older patients and examine the outcomes of PD compared to hemodialysis (HD) in old patients segmented into chronological age groups in order to study modality-based survival as age advances.

Methods

We utilized the United States Renal Data System (USRDS) to track the survival of patients with ESRD who started dialysis between 2001-2014. Survival of patients on PD and HD was compared in three age groups: age 65-74, age 75-84, and age >85. Comparisons of PD and HD were adjusted for sex, year of initiation of dialysis and number of comorbidities, and mortality rates were calculated.

Results

A total of 743,229 patients were analyzed in the 3 different age categories. Prevalence of PD use was lower as age progressed, with 6%, 4%, and 3% of patients using PD in the three age groups: 65-74 (N=21,776), 75-84 (N=11,978), >85 (N=2,426), respectively, (Table 1). PD was associated with lower mortality compared to HD across all age groups after adjustment for sex, race and number of comorbidities, (Table 2).

Conclusion

PD is underutilized in the older population but overall is associated with a lower mortality in these patients. Despite comorbidity adjustments, it is possible that PD patients are inherently healthier than HD patients. However, the results of this study should encourage providers to strongly consider PD as an option in older patients.