Home Dialysis Among Elderly Patients: Outcomes and Future Directions

Overview

Journal Can J Kidney Health Dis

Publisher Sage Publications

Date 2019 Sep 17

PMID 31523436

Citations 6

Authors

Bourne L Auguste

Christopher T Chan

Affiliations

Soon will be listed here.

Abstract

Elderly patients who receive home dialysis (peritoneal dialysis or home hemodialysis) may have reduced survival compared to younger patients. Therefore, it is important to ascertain the goals of home dialysis in the elderly rather than simply fixate on standard metrics such as technique survival. As Canada's population continues to age, the prevalence of end-stage kidney disease among the elderly population is increasing. Patients with multiple comorbidities are now surviving long enough to be started on dialysis. Although home dialysis has been associated with better survival and improved quality of life, its impact on the frail and elderly populations require further elucidation. Home dialysis patients can either independently perform tasks or have support in the home to safely conduct dialysis. Moreover, patients burdened with frailty and multiple comorbidities who lack support in the home may not be able to perform home dialysis safely. Innovative strategies to improve accessibility to home-based therapies need further exploration. In addition, the concept of goal-directed dialysis promotes more individualized treatment. Future continuous quality improvement initiatives must examine if goal-directed dialysis leads to better quality of life outcomes in the elderly.

Citing Articles

Delivering Personalized, Goal-Directed Care to Older Patients Receiving Peritoneal Dialysis.

Wu H, Poulikakos D, Hurst H, Lewis D, Chinnadurai R Kidney Dis (Basel). 2023; 9(5):358-370.

PMID: 37901709 PMC: 10601915. DOI: 10.1159/000531367.

Home dialysis in older adults: challenges and solutions.

Wu H, Dhaygude A, Mitra S, Tennankore K Clin Kidney J. 2023; 16(3):422-431.

PMID: 36865019 PMC: 9972827. DOI: 10.1093/ckj/sfac220.

A decade of arteriovenous fistula creations in the ⩾75 years population: Equal opportunity or sub-optimal use of resources.

Corr M, Pachchigar A, ONeill M, Higgins R, ONeill S, Hanko J J Vasc Access. 2023; 25(4):1093-1099.

PMID: 36609176 PMC: 11308278. DOI: 10.1177/11297298221147571.

Assisted Peritoneal Dialysis Implementation: A Pilot Program From a Large Dialysis Unit in Quebec.

Melanson J, Kachmar J, Laurin L, Elftouh N, Nadeau-Fredette A Can J Kidney Health Dis. 2022; 9:20543581221113387.

PMID: 35875413 PMC: 9305165. DOI: 10.1177/20543581221113387.

Outcomes of peritoneal dialysis in elderly vs non-elderly patients: A systemic review and meta-analysis.

Jiang C, Zheng Q PLoS One. 2022; 17(2):e0263534.

PMID: 35134073 PMC: 8824377. DOI: 10.1371/journal.pone.0263534.

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