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Dialysis

Dialysis options—elderly patients should be given an informed choice

Nature Reviews Nephrology volume 7, page 4 (2011)Cite this article

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Use of peritoneal dialysis in the elderly is declining; thus, Edwina Brown and co-workers first identified 70 older patients (aged >65 years) on peritoneal dialysis, and then compared them with 70 patients on hemodialysis, matched for age, sex, time on dialysis, ethnicity and residential area. Validated tools were used to assess the intrusiveness of illness as well as overall quality of life. “It was important to determine how patients live and cope with their dialysis,” stresses lead researcher Brown. Surprisingly, peritoneal dialysis offered clear advantages: “Older patients on peritoneal dialysis have a better quality of life ... than do those on hemodialysis”, concludes Brown, who highlights attitudes among clinicians as a possible factor underlying the shift towards hemodialysis. Older patients tend to have comorbidities, which increase the risk of dialysis complications. Furthermore, they are often presumed to have impaired independence and decreased ability to perform peritoneal self-dialysis.

In reality, few data actually support these negative perceptions. Brown is hopeful that the BOLDE findings will change health-care professionals' views about the suitability of peritoneal dialysis for elderly patients—who are unlikely to ever receive a kidney transplant, and thus will be on dialysis until the end of their life. From this perspective, peritoneal dialysis offers important benefits; for example, this home-based therapy causes less disruption to the lifestyles of the patient and their family than does hemodialysis.

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ORIGINAL RESEARCH PAPER

  1. Brown, E. A. et al. Broadening Options for Long-term Dialysis in the Elderly (BOLDE): differences in quality of life on peritoneal dialysis compared to haemodialysis for older patients. Nephrol. Dial. Transplant. 25, 3755–3763 (2010)

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  1. Steven E. Bradshaw
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Bradshaw, S. Dialysis options—elderly patients should be given an informed choice. Nat Rev Nephrol 7, 4 (2011). https://doi.org/10.1038/nrneph.2010.162

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  • DOI: https://doi.org/10.1038/nrneph.2010.162

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