The utility of a structured evaluation of elderly patients for continuous peritoneal dialysis

Abstract

The elderly comprise an increasing proportion of chronic dialysis patients. Recruiting them for continuous peritoneal dialysis (CPD) would help CPD programs maintain a patient population. We retrospectively studied the ability of a prospective evaluation to predict success with CPD in elderly (age >60 years) patients. PD nurses and a renal social worker assigned scores in 10 categories, which were then averaged to obtain an overall evaluation score. Scores were from 1-5 with 1 = good, 5 = poor, and 3 = average. Thirty-four elderly patients began CPD during the study period. Evaluation scores were available for 28 of these patients before they began dialysis. Evaluation scores <3 predicted success with CPD (2.2 ± 0.2 versus 3.2 ± 0.4 in patients transferring to hemodialysis, p < 0.02). Patient motivation and preference were the categories that predicted success with CPD. Elderly patients were more likely than younger patients (those <60 years of age) to decline CPD for social reasons (46% versus 4% respectively, p < 0.001). Elderly patients required more CPD training time than young patients (4.9 ± 0.7 days versus 3.3 ± 0.8 days respectively, p < 0.01). We conclude that a prospective assessment of elderly patients can predict success with CPD and provide information important to individual structuring of CPD training and follow-up.