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Kidney Week

Abstract: PO0976

Effect of Low-Dose PD in Elder Population on Protein Energy Wasting, Functionality, and Quality of Life

Session Information

  • Peritoneal Dialysis
    November 04, 2021 | Location: On-Demand, Virtual Only
    Abstract Time: 10:00 AM - 12:00 PM

Category: Dialysis

  • 702 Dialysis: Home Dialysis and Peritoneal Dialysis

Authors

  • García Villalobos, Gloria Guadalupe, Hospital General de Mexico Dr Eduardo Liceaga, Ciudad de Mexico, Ciudad de Mexico, Mexico
  • Perez-Navarro, L. Monserrat, Hospital General de Mexico Dr Eduardo Liceaga, Ciudad de Mexico, Ciudad de Mexico, Mexico
  • Valdez-Ortiz, Rafael, Hospital General de Mexico Dr Eduardo Liceaga, Ciudad de Mexico, Ciudad de Mexico, Mexico
Background

Elder population currently involves 55% of those who initiate dialysis. Age, comorbidities, functional status (FS), protein energy wasting (PEW) and quality of life (QoL) need to be considered. CAPD can cause PEW, loss of functionality and QoL decline, adjusting treatment to Intermittent Ambulatory PD (IAPD) (low-dose) has the intention to decrease disadvantages while maintaining the benefits.
The aim of this study was to to evaluate the effect of low-dose PD on PEW, functionality and QoL.

Methods

A retrospective cohort of patients 60 years and older was analyzed. IAPD was defined as less than 16hrs of treatment per day. Clinical, biochemical data were collected. Katz, Lawton-Brody scales and EQ-5D-5L questionnaire were applied.

Results

91 patients were on IAPD: Prescription of hrs/day of dialysis did not correlate with residual uresis (r -0.052, p 0.612). Questionnaires: QoL. EQ-5D-5L found the majority of patients were in the highest/positive scores for every category assessed. In the same way, 44% of the patients had 80 points or more in their perception of QoL (figure 1), and it was found to be associated with albumin and phosphorus (r.296, p 0.015; r .312, p 0.027). Functionality. 67% of patients were classified as independent (figure 2) and FS was associated with albumin, uresis and VAS QoL (r 0.462, p0.000; r 0.416, p0.000; r 0.407, p0.000 respectively). A model to identify the predictors of functionality was made. It was found that female, age >75y, uresis<500ml/d, albumin <3.5g/dl and hours of dialysis predict negatively scores. The interaction between hours of dialysis and age have the biggest effect size.

Conclusion

IAPD in this elder population does not mean suboptimal dialysis: there were found favorable results in regard to biochemical parameters; FS and QoL scores maintained despite the dialysis vintage. Of notice the group of 75years and older are more likely to be affected in a negative way by prescription of dialysis.