Peritoneal dialysis for older people: overcoming the barriers.

The proportion of older dialysis patients on peritoneal dialysis (PD) is considerably lower than that of younger patients. This is despite the fact that clinical outcome studies show that older patients cope at least as well as younger patients with PD, and that many older patients do not cope well with hemodialysis (HD). Barriers to PD include medical and social factors, physician bias, late referral, and education not tailored to the needs of older patients. The development of assisted PD can overcome some of the barriers and enable frail older patients to have home-based dialysis treatment.