Nutrition in Older Adults on Peritoneal Dialysis

Abstract

Nutrition in older adults on peritoneal dialysis is an important aspect of a patient's clinical management as well as being influenced by their overall well-being, both mental and physical. This is especially pertinent as individuals age, since the potential impact of life changes and physical changes contribute to the development of protein-energy wasting and potentially exacerbating sarcopenia and wasting. This article provides an outline of the nutritional issues to consider in older adults on peritoneal dialysis (PD). Perit Dial Int

The Relevance of Geriatric Impairments in Patients Starting Dialysis: A Systematic Review

“…Where lacking, ORs were calculated on the basis of the presented data for optimizing comparability of the data (calculator Vassar College) (5).…”

“…There may be considerable interaction between various domains. For instance, elderly patients are at higher risk for malnutrition because of dentition loss and gastrointestinal symptoms, but mood and social circumstances may additionally compromise nutritional status (5). Accumulation and interaction of impairment of multiple domains may contribute to increased vulnerability to external stressors, also referred to as the (renal) frailty phenotype (6).…”

Peritoneal dialysis has optimal intradialytic hemodynamics and preserves residual renal function: Why isn't it better than hemodialysis?

“…34 To put this into perspective, 60 g of glucose provides 232 kCal of energy; in the study by Grodstein, dialysate glucose accounted for up to 34% of patients' total daily energy intake. 34 Current PD nutrition guidelines suggest that assessments of energy requirements include calories from peritoneal absorption of glucose, 35 but do not recommend a limit on the proportion that comes from dialysate glucose; it is interesting to note that current US dietary guidelines for the general population suggest that <10% of total daily energy should come from sugars to prevent obesity. 36 But what are the consequences of glucose absorption?…”

Oral nutritional supplementation in patients undergoing peritoneal dialysis: a randomised, crossover pilot study

“…Patients on PD more often report onset of GI symptoms at commencement of the therapy (Salamon et al 2013, Dong et al 2014. Older people (65 years) on PD may be particularly vulnerable to malnutrition, with GI symptoms particularly compromising intake in this group (Johanssen 2015).…”

“…). Older people (≥65 years) on PD may be particularly vulnerable to malnutrition, with GI symptoms particularly compromising intake in this group (Johanssen ).…”