The Utility of a Structured Evaluation of Elderly Patients for Continuous Peritoneal Dialysis

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Abstract
The elderly comprise an increasing proportion of chronic dialysis patients. Recruiting them for continuous peritoneal dialysis (CPO) would help CPO programs maintain a patient population. We retrospectively studied the ability of a prospective evaluation to predict success with CPO in elderly (age >60 years) patients. PO nurses and a renal social worker assigned scores in 10 categories, which were then averaged to obtain an overall evaluation score. Scores were from 1–5 with 1 = good, 5 = poor, and 3 = average. Thirty-four elderly patients began CPO during the study period. Evaluation scores were available for 28 of these patients before they began dialysis. Evaluation scores <3 predicted success with CPO (2.2:1:0.2 versus 3.2:1:0.4 in patients transferring to hemodialysis, p<0.02). Patient motivation and preference were the categories that predicted success with CPO. Elderly patients were more likely than younger patients (those <60 years of age) to decline CPO for social reasons (46% versus 4% respectively, p<0.001). Elderly patients required more CPO training time than young patients (4.9:1:0.7 days versus 3.3:1:0.8 days respectively, p<0.01). We conclude that a prospective assessment of elderly patients can predict success with CPO and provide information important to individual structuring of CPO training and follow-up.

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