Abstract: TH-PO302
Elderly Patients in Peritoneal Dialysis: Concerns Regarding Albumin Loss
Session Information
- Peritoneal Dialysis: CVD, Fluid, Nutrition
November 07, 2019 | Location: Exhibit Hall, Walter E. Washington Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Dialysis
- 703 Dialysis: Peritoneal Dialysis
Authors
- Gois, Jeison, Universidade de Sao Paulo, Sao Paulo, Brazil
- Costa, Rebeca, Universidade de Sao Paulo, Sao Paulo, Brazil
- Barbosa, Géssica Sabrine braga, Universidade de Sao Paulo, Sao Paulo, Brazil
- Cordeiro, Lilian, Universidade de Sao Paulo, Sao Paulo, Brazil
- Pereira, Benedito J., Universidade de Sao Paulo, Sao Paulo, Brazil
- Abensur, Hugo, Universidade de Sao Paulo, Sao Paulo, Brazil
- Moyses, Rosa M.A., Universidade de Sao Paulo, Sao Paulo, Brazil
- Elias, Rosilene M., Universidade de Sao Paulo, Sao Paulo, Brazil
Background
Albumin loss in peritoneal dialysis is associated with morbidity and mortality among patients on peritoneal dialysis (PD). Since elderly patients had a higher risk of protein-energy wasting, there has been a concern of further impairment of nutritional status in this population.
Methods
This is an observational prospective study that included patients >65 years (elderly group, N=18) compared to patients <65 years (younger group, N=73). Patients were followed for a median period of 21.8 months after PD initiation in a single center.
Results
Patients >65years (50% diabetic, 78% men) started PD with a residual diuresis of 1.4± 0.5L, which did not differ from the young group (1.5± 0.7L); p=0.778. Elderly patients had lower serum creatinine (p=0.0001), serum phosphate (p=0.010), total protein (p=0.010), and higher bicarbonate (p=0.003), denoting impaired nutritional status. Serum 25(OH)-vitamin D at PD initiation was similar between groups (p=0.705). During follow-up, there was a slightly reduction of serum albumin in young patients (from 3.76±0.5 to 3.62±0.6mg/dl, p=0.0001), which did not reach statistical significance in the elderly population (from 3.67±0.4 to 3.57±0.4mg/dl, p=0.335), with a median change overtime of 0.14 and 0.10mg/dl in young and elderly patients, respectively (p=0.834). As expected, there was a weight increase over time, although not different comparing young and elderly patients (p=0.579). In addition, loss of residual renal function, and changes in hemoglobin, serum ferritin, iron saturation, β-2 microglobulin, and parathormone were similar between groups (all p>0.05).
Conclusion
Our findings suggest that there is no medical concern to avoid PD therapy in elderly patients with end-stage renal disease, at least in those who start therapy with no critical nutritional condition.