Elderly peritoneal dialysis compared with elderly hemodialysis patients and younger peritoneal dialysis patients: Competing risk analysis of a Korean prospective cohort study

CRC for ESRD Investigators

doi:10.1371/journal.pone.0131393

Elderly peritoneal dialysis compared with elderly hemodialysis patients and younger peritoneal dialysis patients: Competing risk analysis of a Korean prospective cohort study

CRC for ESRD Investigators

Department of Internal Medicine

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27 Citations (Scopus)

Abstract

The outcomes of peritoneal dialysis (PD) in elderly patients have not been thoroughly investigated. We aimed to investigate the clinical outcomes and risk factors associated with PD in elderly patients. We conducted a prospective observational nationwide adult end-stage renal disease (ESRD) cohort study in Korea from August 2008 to March 2013. Among incident patients (n = 830), patient and technical survival rate, quality of life, and Beck's Depression Inventory (BDI) scores of elderly PD patients (≥65 years, n = 95) were compared with those of PD patients aged ≤49 years (n = 205) and 50∼64 years (n = 192); and elderly hemodialysis (HD) patients (n = 315). The patient death and technical failure were analyzed by cumulative incidence function. Competing risk regressions were used to assess the risk factors for survival. The patient survival rate of elderly PD patients was inferior to that of younger PD patients (P<0.001). However, the technical survival rate was similar (P = 0.097). Compared with elderly HD patients, the patient survival rate did not differ according to dialysis modality (P = 0.987). Elderly PD patients showed significant improvement in the BDI scores, as compared with the PD patients aged ≤49 years (P = 0.003). Low albumin, diabetes and low residual renal function were significant risk factors for the PD patient survival; and peritonitis was a significant risk factor for technical survival. Furthermore, low albumin and hospitalization were significant risk factors of patient survival among the elderly. The overall outcomes were similar between elderly PD and HD patients. PD showed the benefit in BDI and quality of life in the elderly. Additionally, the technical survival rate of elderly PD patients was similar to that of younger PD patients. Taken together, PD may be a comparable modality for elderly ESRD patients.

Original language	English
Article number	e0131393
Journal	PloS one
Volume	10
Issue number	6
DOIs	https://doi.org/10.1371/journal.pone.0131393
Publication status	Published - 2015 Jun 29

Bibliographical note

Publisher Copyright:
© 2015 Kim et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

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10.1371/journal.pone.0131393

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@article{d56d1b76d29f46f18573f0f9bd3bafbc,

title = "Elderly peritoneal dialysis compared with elderly hemodialysis patients and younger peritoneal dialysis patients: Competing risk analysis of a Korean prospective cohort study",

abstract = "The outcomes of peritoneal dialysis (PD) in elderly patients have not been thoroughly investigated. We aimed to investigate the clinical outcomes and risk factors associated with PD in elderly patients. We conducted a prospective observational nationwide adult end-stage renal disease (ESRD) cohort study in Korea from August 2008 to March 2013. Among incident patients (n = 830), patient and technical survival rate, quality of life, and Beck's Depression Inventory (BDI) scores of elderly PD patients (≥65 years, n = 95) were compared with those of PD patients aged ≤49 years (n = 205) and 50∼64 years (n = 192); and elderly hemodialysis (HD) patients (n = 315). The patient death and technical failure were analyzed by cumulative incidence function. Competing risk regressions were used to assess the risk factors for survival. The patient survival rate of elderly PD patients was inferior to that of younger PD patients (P<0.001). However, the technical survival rate was similar (P = 0.097). Compared with elderly HD patients, the patient survival rate did not differ according to dialysis modality (P = 0.987). Elderly PD patients showed significant improvement in the BDI scores, as compared with the PD patients aged ≤49 years (P = 0.003). Low albumin, diabetes and low residual renal function were significant risk factors for the PD patient survival; and peritonitis was a significant risk factor for technical survival. Furthermore, low albumin and hospitalization were significant risk factors of patient survival among the elderly. The overall outcomes were similar between elderly PD and HD patients. PD showed the benefit in BDI and quality of life in the elderly. Additionally, the technical survival rate of elderly PD patients was similar to that of younger PD patients. Taken together, PD may be a comparable modality for elderly ESRD patients.",

author = "{CRC for ESRD Investigators} and Hyunsuk Kim and An, {Jung Nam} and Kim, {Dong Ki} and Kim, {Myoung Hee} and Ho Kim and Kim, {Yong Lim} and Park, {Ki Soo} and Oh, {Yun Kyu} and Lim, {Chun Soo} and Kim, {Yon Su} and Lee, {Jung Pyo} and Do, {J. Y.} and Song, {S. H.} and Kim, {S. E.} and Kim, {S. H.} and Kim, {Y. H.} and Lee, {J. S.} and Jin, {H. J.} and Chang, {J. H.} and Yoo, {T. H.} and Park, {J. T.} and Oh, {H. J.} and Park, {H. C.} and Chang, {T. I.} and Ryu, {D. R.} and Oh, {D. J.} and Chang, {Y. S.} and Kim, {Y. O.} and Kim, {S. H.} and Jin, {D. C.} and Kim, {Y. K.} and Kim, {H. Y.} and W. Kim and Lee, {K. W.} and Lee, {C. S.}",

note = "Publisher Copyright: {\textcopyright} 2015 Kim et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.",

year = "2015",

month = jun,

day = "29",

doi = "10.1371/journal.pone.0131393",

language = "English",

volume = "10",

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issn = "1932-6203",

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TY - JOUR

T1 - Elderly peritoneal dialysis compared with elderly hemodialysis patients and younger peritoneal dialysis patients

T2 - Competing risk analysis of a Korean prospective cohort study

AU - CRC for ESRD Investigators

AU - Kim, Hyunsuk

AU - An, Jung Nam

AU - Kim, Dong Ki

AU - Kim, Myoung Hee

AU - Kim, Ho

AU - Kim, Yong Lim

AU - Park, Ki Soo

AU - Oh, Yun Kyu

AU - Lim, Chun Soo

AU - Kim, Yon Su

AU - Lee, Jung Pyo

AU - Do, J. Y.

AU - Song, S. H.

AU - Kim, S. E.

AU - Kim, S. H.

AU - Kim, Y. H.

AU - Lee, J. S.

AU - Jin, H. J.

AU - Chang, J. H.

AU - Yoo, T. H.

AU - Park, J. T.

AU - Oh, H. J.

AU - Park, H. C.

AU - Chang, T. I.

AU - Ryu, D. R.

AU - Oh, D. J.

AU - Chang, Y. S.

AU - Kim, Y. O.

AU - Kim, S. H.

AU - Jin, D. C.

AU - Kim, Y. K.

AU - Kim, H. Y.

AU - Kim, W.

AU - Lee, K. W.

AU - Lee, C. S.

N1 - Publisher Copyright: © 2015 Kim et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

PY - 2015/6/29

Y1 - 2015/6/29

N2 - The outcomes of peritoneal dialysis (PD) in elderly patients have not been thoroughly investigated. We aimed to investigate the clinical outcomes and risk factors associated with PD in elderly patients. We conducted a prospective observational nationwide adult end-stage renal disease (ESRD) cohort study in Korea from August 2008 to March 2013. Among incident patients (n = 830), patient and technical survival rate, quality of life, and Beck's Depression Inventory (BDI) scores of elderly PD patients (≥65 years, n = 95) were compared with those of PD patients aged ≤49 years (n = 205) and 50∼64 years (n = 192); and elderly hemodialysis (HD) patients (n = 315). The patient death and technical failure were analyzed by cumulative incidence function. Competing risk regressions were used to assess the risk factors for survival. The patient survival rate of elderly PD patients was inferior to that of younger PD patients (P<0.001). However, the technical survival rate was similar (P = 0.097). Compared with elderly HD patients, the patient survival rate did not differ according to dialysis modality (P = 0.987). Elderly PD patients showed significant improvement in the BDI scores, as compared with the PD patients aged ≤49 years (P = 0.003). Low albumin, diabetes and low residual renal function were significant risk factors for the PD patient survival; and peritonitis was a significant risk factor for technical survival. Furthermore, low albumin and hospitalization were significant risk factors of patient survival among the elderly. The overall outcomes were similar between elderly PD and HD patients. PD showed the benefit in BDI and quality of life in the elderly. Additionally, the technical survival rate of elderly PD patients was similar to that of younger PD patients. Taken together, PD may be a comparable modality for elderly ESRD patients.

AB - The outcomes of peritoneal dialysis (PD) in elderly patients have not been thoroughly investigated. We aimed to investigate the clinical outcomes and risk factors associated with PD in elderly patients. We conducted a prospective observational nationwide adult end-stage renal disease (ESRD) cohort study in Korea from August 2008 to March 2013. Among incident patients (n = 830), patient and technical survival rate, quality of life, and Beck's Depression Inventory (BDI) scores of elderly PD patients (≥65 years, n = 95) were compared with those of PD patients aged ≤49 years (n = 205) and 50∼64 years (n = 192); and elderly hemodialysis (HD) patients (n = 315). The patient death and technical failure were analyzed by cumulative incidence function. Competing risk regressions were used to assess the risk factors for survival. The patient survival rate of elderly PD patients was inferior to that of younger PD patients (P<0.001). However, the technical survival rate was similar (P = 0.097). Compared with elderly HD patients, the patient survival rate did not differ according to dialysis modality (P = 0.987). Elderly PD patients showed significant improvement in the BDI scores, as compared with the PD patients aged ≤49 years (P = 0.003). Low albumin, diabetes and low residual renal function were significant risk factors for the PD patient survival; and peritonitis was a significant risk factor for technical survival. Furthermore, low albumin and hospitalization were significant risk factors of patient survival among the elderly. The overall outcomes were similar between elderly PD and HD patients. PD showed the benefit in BDI and quality of life in the elderly. Additionally, the technical survival rate of elderly PD patients was similar to that of younger PD patients. Taken together, PD may be a comparable modality for elderly ESRD patients.

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UR - http://www.scopus.com/inward/citedby.url?scp=84938688945&partnerID=8YFLogxK

U2 - 10.1371/journal.pone.0131393

DO - 10.1371/journal.pone.0131393

M3 - Article

C2 - 26121574

AN - SCOPUS:84938688945

SN - 1932-6203

VL - 10

JO - PloS one

JF - PloS one

IS - 6

M1 - e0131393

ER -

Elderly peritoneal dialysis compared with elderly hemodialysis patients and younger peritoneal dialysis patients: Competing risk analysis of a Korean prospective cohort study

Abstract

Bibliographical note

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UN SDGs

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