Peritoneal dialysis for the elderly

Abstract

The default dialysis choice for the elderly is usually haemodialysis in most European countries, Canada and the USA with relatively few patients starting on peritoneal dialysis (PD) compared to younger and fitter patients. This is actually quite surprising as a home-based treatment avoids the need for transport and peritoneal dialysis (PD) does not have the haemodynamic swings associated with haemodialysis (HD). There is no doubt that there are often challenges to enabling an elderly patient to have PD, but the development of assisted PD can surmount many of these. Indeed, in France where assisted PD has been available for many years, the PD population is predominantly elderly [1]. As discussed in Chapter (Choosing Dialysis Modality), the BOLDE study has shown that PD patients have less illness and treatment intrusion than patients on HD [2], though the patients in the study were mainly fitter older patients and none were on assisted PD.