Abstract: FR-PO0540
Improved Long-Term Outcomes in Elderly Patients on Peritoneal Dialysis over 25 Years: A Single-Center Cohort Study
Session Information
- Home Dialysis: Clinical Epidemiology
November 07, 2025 | Location: Exhibit Hall, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Dialysis
- 802 Dialysis: Home Dialysis and Peritoneal Dialysis
Authors
- Kim, In Soo, Hallym University Sacred Heart Hospital, Anyang-si, Gyeonggi-do, Korea (the Republic of)
- Moon, Sung Jin, Catholic Kwandong University International Saint Mary's Hospital, Incheon, Korea (the Republic of)
- Kim, Jwa-kyung, Hallym University Sacred Heart Hospital, Anyang-si, Gyeonggi-do, Korea (the Republic of)
Background
With the aging population, the need for dialysis among elderly patients is increasing. While most receive hemodialysis (HD), peritoneal dialysis (PD) remains a beneficial and feasible dialysis modality. However, data on long-term outcomes and temporal trends in elderly PD patients are limited.
Methods
We conducted a retrospective cohort study of 540 incident PD patients between 1999 and 2024. Patients were categorized into three time periods (1999–2007, 2008–2016, and 2017–2024) and stratified into three age groups (<50, 50–64, and ≥65 years). The primary outcomes were all-cause mortality, technical failure (defined as transition to HD), and a composite of the two. Kaplan–Meier survival analysis was used to estimate 1-, 3-, and 5-year survival rates, and Cox proportional hazards models were employed to evaluate temporal trends in outcomes.
Results
The proportion of elderly individuals remained stable across the three periods, at approximately 21%, with a mean age of 70.6 ± 4.7 years. Compared to non-elderly patients, elderly individuals were more likely to have diabetes (66.7% vs. 57.3%), had a shorter median PD duration (28.6 vs. 39were presented), and presented with lower blood pressure, hemoglobin, albumin, and creatinine levels. Overall, survival outcomes among PD patients improved significantly over time. In the total population, 5-year survival increased from 55.6% in 1999–2007 to 89.1% in 2017–2024, reflecting substantial reductions in mortality across all age groups. The improvement was particularly notable among the elderly. In this group, 3-year survival rates increased from 70.4% in 1999–2007 to 86.2% in 2008–2016 and 92.0% in 2017–2024, while 5-year survival improved from 42.4% to 63.4% and 75.6%, respectively. Although technical survival remained relatively unchanged over time—with 5-year technique failure rates in the elderly ranging from 52.5% to 56.4%—the composite outcomes in elderly patients improved markedly, primarily driven by the gains in overall survival.
Conclusion
Outcomes for elderly PD patients have significantly improved over time, despite their stable proportion in the PD population. These findings suggest that advances in PD care, rather than changes in patient selection, have led to better outcomes, supporting its use in older adults in current practice.
Funding
- Clinical Revenue Support