OBJECTIVE: To compare clinical outcomes and quality of life (QOL) in elderly patients on peritoneal dialysis (PD) and hemodialysis (HD) in the North Thames Dialysis Study. DESIGN: A 12-month prospective cohort study. SETTING: Four hospital-based renal units in London, UK. PATIENTS: 174 patients that were 70 years or older at the start of dialysis, separated into two cohorts: 78 new patients (36 PD, 42 HD) that were recruited after 90 days of chronic dialysis; and 96 stock patients (42 PD, 54 HD) that were already on dialysis during the recruitment period. MAIN OUTCOME MEASURES: 12-month survival and hospitalization rate, and QOL assessed at baseline and at 6 and 12 months by the SF-36 and the Symptoms/Problems scale of the Kidney Disease Quality of Life Questionnaire (KDQOL). RESULTS: Peritoneal dialysis and HD patients were similar for sociodemographic and clinical characteristics. Annual mortality and hospitalization rates in PD versus HD patients were 26.1 versus 26.4 deaths/100 person-years and 1.9 versus 2.0 admissions/person-year, respectively. Adjusted relative risks showed no effect of modality on clinical outcomes. Multiple linear regression analyses of QOL at baseline showed similar SF-36 scores between PD and HD patients, but higher KDQOL scores in PD patients (3.5 points higher, 95% confidence interval 0.3-6.6). There was, however, no effect of dialysis modality on QOL at 6 or 12 months. CONCLUSIONS: Clinical outcomes and QOL are similar in elderly people on PD and HD. Peritoneal dialysis is a viable option for more than a carefully selected minority of elderly people requiring dialysis.
OBJECTIVE: To compare clinical outcomes and quality of life (QOL) in elderly patients on peritoneal dialysis (PD) and hemodialysis (HD) in the North Thames Dialysis Study. DESIGN: A 12-month prospective cohort study. SETTING: Four hospital-based renal units in London, UK. PATIENTS: 174 patients that were 70 years or older at the start of dialysis, separated into two cohorts: 78 new patients (36 PD, 42 HD) that were recruited after 90 days of chronic dialysis; and 96 stock patients (42 PD, 54 HD) that were already on dialysis during the recruitment period. MAIN OUTCOME MEASURES: 12-month survival and hospitalization rate, and QOL assessed at baseline and at 6 and 12 months by the SF-36 and the Symptoms/Problems scale of the Kidney Disease Quality of Life Questionnaire (KDQOL). RESULTS: Peritoneal dialysis and HDpatients were similar for sociodemographic and clinical characteristics. Annual mortality and hospitalization rates in PD versus HDpatients were 26.1 versus 26.4 deaths/100 person-years and 1.9 versus 2.0 admissions/person-year, respectively. Adjusted relative risks showed no effect of modality on clinical outcomes. Multiple linear regression analyses of QOL at baseline showed similar SF-36 scores between PD and HDpatients, but higher KDQOL scores in PDpatients (3.5 points higher, 95% confidence interval 0.3-6.6). There was, however, no effect of dialysis modality on QOL at 6 or 12 months. CONCLUSIONS: Clinical outcomes and QOL are similar in elderly people on PD and HD. Peritoneal dialysis is a viable option for more than a carefully selected minority of elderly people requiring dialysis.
Authors: Robert R Quinn; Pietro Ravani; Xin Zhang; Amit X Garg; Peter G Blake; Peter C Austin; James M Zacharias; John F Johnson; Sanjay Pandeya; Mauro Verrelli; Matthew J Oliver Journal: Perit Dial Int Date: 2014 Jan-Feb Impact factor: 1.756
Authors: Edwina A Brown; Lina Johansson; Ken Farrington; Hugh Gallagher; Tom Sensky; Fabiana Gordon; Maria Da Silva-Gane; Nigel Beckett; Mary Hickson Journal: Nephrol Dial Transplant Date: 2010-04-16 Impact factor: 5.992
Authors: Tushar J Vachharajani; Louise M Moist; Marc H Glickman; Miguel A Vazquez; Kevan R Polkinghorne; Charmaine E Lok; Timmy C Lee Journal: Nat Rev Nephrol Date: 2013-12-03 Impact factor: 28.314