Clinical outcomes and complication rates of peritoneal dialysis in elderly patients: an 18-year retrospective analysis

Abstract

Peritoneal dialysis (PD) is a gentle, self-managed modality that offers significant benefits for elderly patients with end-stage kidney disease (ESKD), particularly in preserving residual kidney function (RKF). Despite its advantages, PD remains underutilized in this population. This retrospective study evaluated clinical, nutritional, and metabolic outcomes, as well as quality of life, in 164 patients initiating PD, comparing elderly patients (≥65 years, n=22; mean age 71.1±5.5 years) to younger counterparts (<65 years, n=142; mean age 42.8±13.2 years). Parameters were assessed at baseline and after 24 months. Initially, the elderly group had a higher Charlson comorbidity index and lower RKF. Serum creatinine was the only significantly lower marker in older patients, with other metabolic and clearance parameters showing no notable differences. After 24 months, both groups exhibited improved clearance of urea, potassium, and alkaline reserves. In the elderly, serum albumin decreased and triglycerides increased significantly. Complication rates were similar across groups. While not statistically significant, elderly patients showed better technique survival but higher mortality, primarily from cardiovascular causes. These findings suggest that PD is a viable and safe treatment option for elderly ESKD patients, yielding comparable outcomes to younger individuals. However, ongoing monitoring of comorbidities and nutritional status remains crucial to optimize care in this population.