DIFFERENCES IN PERITONEAL TRANSPORT TYPE BEWEEN NON-GERIATRIC AND GERIATRIC PERITONEAL DIALYSIS PATIENTS
Peritoneal dialysis is a well accepted home based dialysis strategy even in geriatric patients.
The effect of age on functional parameters of the peritoneum is not well known.
The aim of the study was to evaluate differences in peritoneal transport status between non geriatric and geriatric peritoneal dialysis patients.
Patient 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 of 78 years.
Geriatric patients showed lower urine output (median 700 versus 1350 ml, p<0.001), lower weekly renal creatinine clearance (median 44 versus 65 ml/week, p=0.047) and lower weekly renal urea clearance (median 23 versus 34 ml/week, p=0.02).
There were no statistically significant differences in peritoneal creatinine and urea clearances. Due to the reduced urinary clearances, geriatric patients showed slightly lower total creatinine and urea clearances as well as Kt/V.
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.
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 in both groups related to faster transport status.
Geriatric patients are presenting faster transport rates than non-geriatric patients apparently related to hypoalbuminemia.
This difference should be considered for optimizing peritoneal dialysis and nutritional support.