Selecting Peritoneal Dialysis in the Older Dialysis Population.
Selecting peritoneal dialysis (PD) in older individuals is a complex, multi-step process. At each step, older individuals may not have the opportunity to receive PD unless care is optimized. Older individuals are less likely to complete a PD assessment, because of unstable medical conditions, consideration of palliative care, or reluctance to approach frail patients once they are established on hemodialysis (HD). Older individuals are also more likely to have medical or social conditions that contraindicate PD or to have barriers to self-care PD that may not be overcome with support. Older individuals who are eligible for PD may be reluctant to choose it, leaving HD as the default modality. Finally, receipt of PD may be compromised by urgent HD or PD catheter-related complications at the time of insertion. Despite all these challenges, older patients can do very well on PD, so each step should be well understood and optimized in renal programs to maximize PD use in older patients.
['Oliver|Matthew J|MJ|', 'Quinn|Robert R|RR|']
D000367:Age Factors D000368:Aged D000369:Aged, 80 and over D002423:Cause of Death D015897:Comorbidity D005260:Female D015577:Geriatric Assessment D006801:Humans D007676:Kidney Failure, Chronic D008297:Male D010349:Patient Compliance D018579:Patient Selection D010530:Peritoneal Dialysis D011379:Prognosis D018570:Risk Assessment D016019:Survival Analysis D016896:Treatment Outcome
Peritoneal dialysis barriers caregivers education elderly patient selection