老年人腹膜透析之存活率與管路使用分析

楊鎧伍¹、賴韋宏¹

嘉義基督教醫院 外科部 泌尿科¹

Overall Survival and Techenque Survival in Elderly Peritoneal Dialysis Patients

Kai-Wu Yang¹, Wei-Hong Lai¹

Divisions of Urology, Department of Surgery, Chia-Yi Christian Hospital¹

Purpose: 

   Increasing numbers of elderly patients face decisions about the management of end-stage kidney disease. The outcome of peritoneal dialysis (PD) in elderly patients (age≥65) has been reported to be either slightly inferior or equivalent to that of younger patients. We aimed to investigate the clinical outcomes of overall survival and techenque survival and risk factors associated with PD in elderly patients.

Materials and Methods: 

  A retrospective analysis of patients with end-stage renal disease who underwent a surgical PD catheter insertion procedure between April 2009 and April 2021 were undertaken. The data recorded included age, gender, BMI, hospital stay, operative approach, complications related to PD catheters, morbidity, mortality, and catheter survival. Patient with incomplete data and had second PD catheter insertion were excluded. Analysis of overall and catheter survival were performed using the Kaplan-Meier method.

Results:

   A total 134 patients were included and 35 patients were elderly group. Median follow-up was 23 months (interquartile range 13-43 months). The complication rate was similar to both groups, including peritonitis, tube dysfunction, wound infection and hernia. However, the overall survival and techenique survival rate were significant lower in elderly group (p<0.001). Also, the techenique survival rate was significant lower in elderly group even after excluding the non-catheter related death (p<0.001). Baseline factors independently associated with techenique survival were older age [hazard ratio (HR) 6.809, 95% confidence interval (CI) 2.914-15.912] and complication [hazard ratio (HR) 4.610, 95% confidence interval (CI) 2.033-10.453].

Conclusion: 

        Our results indicate that the outcome of peritoneal dialysis (PD) in elderly patients was inferior to the younger paitents. Mortality rate was higher and the techenique survival was shorter in elderly patients. Risk factor for technique survival in PD patient included older and if complication happened.