Introduction and Aim
Peritoneal dialysis is a well accepted home based dialysis strategy even in geriatric patients. There are discrepant reports about the effect of age on functional parameters of the peritoneum.
The aim of the study was to evaluate differences in peritoneal transport status between non geriatric and geriatric peritoneal dialysis patients.
Patients and Methods
We evaluated the first peritoneal equilibration test after dialysis start (standard 4 hour 2.27% glucose test) together with peritoneal and renal clearance data in non-geriatric (age < 75 years) and geriatric patients (age ≥ 75 years). Data of 120 non-geriatric patients (81 male, 39 female) and of 43 geriatric patients (26 male, 17 female) could be acquired. Mann-Whitney test was used for the comparison of groups.
Median age of non-geriatric patients was 61 years, in confront to geriatric patients with 78 years. Geriatric patients showed lower daily urine output (median 700 ml versus 1350 ml, p<0.001), lower weekly renal creatinine clearance (median 44 ml/week versus 65 ml/week, p=0.047) and lower weekly renal urea clearance (median 23 ml/week versus 34 ml/week, p=0.02). There were no statistically significant differences in peritoneal creatinine and urea clearances.
The distribution of peritoneal transport classes showed more frequently faster transport classes in geriatric patients (geriatric: slow 29.9%, slow average 25.6%, fast average 37.1%, fast 16.3%, non-geriatric: slow 32.5%, slow average 34.2%, fast average 26.7%, fast 6.7%).
There were no statistical differences regarding C-reactive protein, erythrocyte sedimentation rate and haemoglobin values. Hypoalbuminemia (<3.5 g/l) was more frequent in geriatric patients (69.8% versus 38.3%; albumin median: geriatric 3.32 g/l, non-geriatric 3.70 g/l, p=0.003), and associated in both groups to faster transport.
Geriatric patients are presenting faster transport rates than non-geriatric patients due to higher prevalence of hypoalbuminemia. The prevalence of hypoalbuminemia should be taken into consideration for selection of the peritoneal dialysis method and for nutritional counseling.