Peritoneal dialysis in the nursing home

Taşkapan, Hülya; Tam, Paul; LeBlanc, Denise; Ting, Robert; Nagai, Gordon; Chow, Stephen; Fung, Jason; Ng, Paul; Sikaneta, Tabo; Roscoe, Janet; Oreopoulos, Dimitrios G.

doi:10.1007/s11255-010-9714-y

Cited by 24 publications

(25 citation statements)

References 18 publications

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“…There are several reports of successful PD for nursing-home residents [27,28]. In areas where aPD is available to support patients within their homes, 75% of those who chose PD received aPD compared to self-care PD.…”

Section: Home-based Dialysis Solutions For the Elderlymentioning

confidence: 99%

Dialysis Options for End-Stage Renal Disease in Older People

Brown

Johansson

2011

Nephron Clin Pract

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The numbers of older patients requiring dialysis therapy is rising, reflecting the ageing of the general population. Older dialysis patients have a tendency to present later for dialysis, have a higher number of comorbid conditions, are at higher risk of cognitive dysfunction and have increased levels of frailty. These are all barriers to home dialysis therapy so hospital haemodialysis (HD) is the predominant dialysis modality for older patients. Evidence suggests, however, that home treatment with peritoneal dialysis (PD) intrudes less into the life of older patients than hospital HD. Assisted PD is available in some countries and this enables more older patients to be treated in their own homes. Adjustments to patient education also need to be made to accommodate the barriers to learning and decision-making that often exist in older people.

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Section: Home-based Dialysis Solutions For the Elderlymentioning

confidence: 99%

Dialysis Options for End-Stage Renal Disease in Older People

Brown

Johansson

2011

Nephron Clin Pract

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“…The lowest survival rates (i.e., 38%) were reported by Reddy et al in a study of HD patients in which nearly half of the cohort (47%) had initiated HD within 3 months of NH admission 13 . A higher survival rate (i.e., 56%) was reported in a mixed cohort of HD and PD patients in whom only 25% had initiated dialysis within 3 months of admission 11 , while the most favorable survival rate (i.e., 61%) was found in a Canadian population with a median dialysis duration of 31 months 9 . This association was further characterized by Reddy et al in an analysis of survival time according to length of time on HD 13 .…”

Section: Resultsmentioning

confidence: 89%

“…The majority of studies (9 of 14) encompassed study periods between 1985 and 2000. Most studies had multicenter cohorts from various NHs located in the United States, while two studies examined outcomes in NHs located in Toronto, Canada 8,9 . Mean subject age ranged from 63 to 83 years.…”

Section: Resultsmentioning

confidence: 99%

“…No studies examined clinical outcome measures relevant to ESRD and hemodialysis (i.e., anemia, nutrition, bone disease, dialysis adequacy, or hemodialysis access type), although seven studies reported outcomes related to PD, with some consistent and some conflicting findings 6,8,9,12,17,19,20 . In these studies, NH staff were specifically trained to do PD exchanges, and in several studies, nurses from the dialysis unit were available for regular patient assessments and troubleshooting.…”

Section: Resultsmentioning

confidence: 99%

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End-Stage Renal Disease in Nursing Homes: A Systematic Review

Hall

O’Hare

Anderson

et al. 2013

Journal of the American Medical Directors Association

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Objectives/Introduction Demand for nursing home (NH) care by patients with endstage renal disease (ESRD) is likely to increase with growing numbers of older adults initiating chronic dialysis. We completed a systematic review to summarize the literature on NH residents with ESRD. Methods MEDLINE, CINAHL, EMBASE, and relevant conference proceedings were searched to identify articles using the following MESH terms or related key words in the title or abstract: “residential facilities”, “renal dialysis”, “renal replacement therapy”, and “chronic kidney failure”. We selected case control, cohort studies, and clinical trials that included older adults with ESRD (defined as those receiving chronic dialysis or those with Stage 5 chronic kidney disease (CKD)) living in residential care facilities. We abstracted information on study design, quality, and results. Results Of 198 unique citations identified by the search strategy, 14 articles met eligibility criteria. The majority of articles were multicenter studies that were conducted in the 1990s. One study focused on patients with Stage 5 CKD, and the remaining thirteen studies focused on chronic dialysis patients of which eight studies included only peritoneal dialysis (PD) patients, four studies included both PD and hemodialysis (HD) patients, and one study included only HD patients. All studies were observational, no clinical trials were identified, and study design limitations and heterogeneity within study populations were common. Summarizing results across these studies suggests that NH residents with ESRD have limited survival, particularly early after dialysis initiation. Functional impairment is highly prevalent in this population and independently associated with poor outcomes. Conclusions NH residents with ESRD appear to be a particularly vulnerable population, but current information on their prevalence, characteristics, and outcomes is limited. Further research is needed to provide a better understanding of modifiable predictors of survival and functional decline in this population.

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“…On the other hand, in a recent paper, Taskapan et al [32] found a lower rate (5.3%) of transfer from PD to HD and of peritonitis rate (1 episode every 40.3 treatment-months) in PD patients in the nursing home. The differences were possibly the result of better care by the nursing home staff.…”

Section: Discussionmentioning

confidence: 89%