MP520DO THE ELDERLY PATIENTS ON PERITONEAL DIALYSIS HAVE MORE INFECTIOUS RISK? PATIENTS ON PERITONEAL DIALYSIS HAVE MORE INFECTIOUS RISK?

Abstract

Introduction and Aims: Identify predictive factors related to more infections in the elderly patients (≥ 65 years) in Peritoneal Dialysis (PD), to determine if the risk of infection is higher than patients <65 years and if there are differences in the microbiological spectrum. Methods: We identified 100 patients in PD program between 2005 and 2015, divided in two groups: non elderly (< 65 years) and elderly patients (≥ 65 years). It was collected patient data for statistical analysis. We considered as dependent variables: total infections, peritonitis, exit-site and tunnel infections throughout the dialysis period of each patient. Independent variables were: age, gender, time on PD, dialysis modality (CAPD - Continuous ambulatory PD, APD - Automatic PD), etiology of kidney disease, Hypertension, Diabetes mellitus, cerebrovascular disease, ischemic heart disease, heart failure, peripheral artery disease, peritoneal and renal Ktv, total albumin, ferritin and hemoglobin (average of the analytical results obtained in the dialysis period of each patient). Comparisons of characteristics between groups were made using the Chi-square test and Mann-Whitney test and Cox Regression models adjusted to different variables were constructed to identify predictive factors of infectious risk. Results: In this population there were 27 elderly and 73 nonelderly patients, with median ages of 74 and 52 years, median time on PD of 3 and 2,25 years and number of infections/1000 catheter days of 2,7 and 2,8 respectively. In the elderly group, there were more men (74,1% vs. 48%; p=0,017), more patients with diabetic nephropathy (41% vs. 16,4%; p=0,02), higher prevalence of cerebrovascular disease (18,5% vs. 5,5%; p=0,049) and ischemic heart disease (44,4% vs. 19%; p=0,012), lower peritoneal Ktv (0,95 vs. 1,23; p=0,001) and higher renal Ktv (1,1 vs. 0,7; p=0,003). Contrary to the nonelderly group, there were no tunnel infections (0 vs. 12 tunnel infections; p=0,026). We didn't identify predictive factors of an infectious risk. Microbiological spectrum was similar between groups. Conclusions: Contrary to expected, the elderly patients don't appear to have an increased risk of peritonitis or exist-site infection and actually have significant less tunnel infections, despite having more diabetic complications and cardiovascular comorbidities. Factors such as dialysis adequacy, modality of technique or microbiological profile don't seem to have a distinctive role. These results are important to reflect that, in fact, the age isn't associated with higher infectious complications and should not contraindicate this technique, which is known to have good results in this group and should be further encouraged.