Good Patient and Technique Survival in Elderly Patients on Continuous Ambulatory Peritoneal Dialysis

2007 ◽  
Vol 27 (2_suppl) ◽  
pp. 196-201 ◽  
Author(s):  
Philip Kam-Tao Li ◽  
Man Ching Law ◽  
Kai Ming Chow ◽  
Chi-Bon Leung ◽  
Bonnie Ching-Ha Kwan ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
Elderly Patients ◽  
Continuous Ambulatory Peritoneal Dialysis ◽  
Patient Survival ◽  
Self Care ◽  
The Elderly ◽  
Elderly Group ◽  
Control Group ◽  
Technique Survival ◽  
Esrd Patients

The aging population has significant implications for the community. The increasing number of elderly end-stage renal disease (ESRD) patients presses the renal team to find an appropriate management plan. We used a retrospective analysis to study the effectiveness of continuous ambulatory peritoneal dialysis (CAPD) in elderly ESRD patients. Of the 328 CAPD patients recruited for the study, 121 were in the elderly group (≥ 65 years of age), and 207 were in the control group (under 65 years of age). Median age in the elderly group was 71 years, and in the control group, 51 years. The elderly group had a higher prevalence (54.5%) of diabetes mellitus. The 2-year and 5-year rates of patient survival were 89.3% and 54.8% respectively in the elderly group and 92.2% and 62.9% in the control group ( p = 0.19). The 2-year and 5-year rates of technique survival were 84.0% and 45.7% respectively in the elderly group and 80.9% and 49.1% in the control group ( p = 0.75). The probability of a 12-month peritonitis-free period was 76.6% in the elderly group and 76.5% in the control group ( p = 0.75). One hundred elderly patients (82.6% of the group) performed their CAPD exchanges by themselves. We observed no significant difference in clinical outcome—including patient survival, technique survival, and peritonitis-free period—between the elderly self-care CAPD and the elderly assisted CAPD groups. In elderly ESRD patients, CAPD is an effective dialysis modality. A slightly longer training time is to be expected for elderly patients. Self-care CAPD for elderly patients who are capable of performing their own exchanges provides them with an independent home life.

scholarly journals Clinical Outcome in Elderly Patients on Chronic Peritoneal Dialysis: A Retrospective Study from a Single Center in China

2014 ◽  
Vol 34 (3) ◽  
pp. 299-307 ◽  
Author(s):  
Upendra Joshi ◽  
Qunying Guo ◽  
Chunyan Yi ◽  
Rong Huang ◽  
Zhijian Li ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
Elderly Patients ◽  
Serum Albumin ◽  
Patient Survival ◽  
Survival Rates ◽  
The Elderly ◽  
Elderly Group ◽  
Chronic Peritoneal Dialysis ◽  
Lower Serum ◽  
Technique Survival

ObjectivesWe aimed to evaluate clinical outcomes and identify the predictors of mortality in elderly patients undergoing continuous ambulatory peritoneal dialysis (CAPD).MethodsThis retrospective cohort study included all incident CAPD patients treated at our center from 2006 to 2009. Demographic and clinical data on initiation of CAPD and clinical events during the study period were collected. Survival probabilities were generated using the Kaplan–Meier method, and risk factors for mortality were evaluated using Cox proportional hazards models.ResultsOf 805 patients on CAPD, the elderly group (≥65 years; mean age: 71.3 ± 4.3 years) consisted of 148 patients, and the younger group (<65 years; mean age: 43.1 ± 12.2years) consisted of 657 patients. The 1-, 2-, 3-, and 5-year patient survival rates were 97%, 92%, 88%, and 73% for the younger group, and 79%, 67%, 56%, and 30% for elderly group. The patient survival rates were significantly lower for the elderly group than for the younger group ( p = 0.000). However, technique survival did not significantly differ between the groups ( p = 0.559). In the patients overall, the independent predictors of death were old age ( p = 0.003), diabetes ( p = 0.000), cardiovascular disease ( p = 0.006), lower hemoglobin ( p = 0.010), and lower serum albumin ( p = 0.024). Mortality in the elderly patients was associated with advanced age [relative risk (RR): 1.088; 95% confidence interval (CI): 1.027 to 1.153; p = 0.004], diabetes (RR: 2.064; 95% CI: 1.236 to 3.445; p = 0.006), and lower serum albumin (RR: 0.940; 95% CI: 0.897 to 0.985; p = 0.010).ConclusionsThe elderly patients on CAPD experienced technique survival comparable with that of younger patients, but their patient survival was lower. In elderly patients, mortality was determined predominantly by greater age, diabetes, and lower serum albumin. Our results indicate that chronic peritoneal dialysis is a viable dialysis option for elderly patients with end-stage renal disease. Better management of hypoalbuminemia and comorbid conditions might improve survival in elderly PD patients.

How to Improve Survival in Geriatric Peritoneal Dialysis Patients

2007 ◽  
Vol 27 (2_suppl) ◽  
pp. 185-189 ◽  
Author(s):  
Hiramatsu Makoto ◽  
Keyword(s):  
Peritoneal Dialysis ◽  
Elderly Patients ◽  
Nursing Care ◽  
Causes Of Death ◽  
Japanese Society ◽  
Patient Survival ◽  
The Elderly ◽  
Patient Choice ◽  
Technique Survival ◽  
Included Patient

♦ Background Recently, more elderly patients who are independent or able to live at home with the support of family are opting for continuous ambulatory peritoneal dialysis (CAPD). At the end of 2005, the annual statistical survey conducted by the Japanese Society for Dialysis Therapy indicated that the mean age of patients at initiation of dialysis treatment is 66.2 years. Only 3.6% of the overall end-stage renal disease population were treated with CAPD, and this small number of elderly patients was treated with CAPD despite the many merits of peritoneal dialysis (PD) for the elderly. In the present study, we reviewed our experience with patients 65 years of age and older at the start of PD and the results from two multicenter studies on PD treatment in elderly patients in Japan. ♦ Patients and Methods Study 1: Of 313 PD patients at Okayama Saiseikai General Hospital between January 1991 and June 2006, 166 patients 65 years of age and older were studied. The characteristics of these elderly PD patients were reviewed to determine which elderly patients can continue PD for more than 5 years, and what the causes of death and the effects of icodextrin were in elderly PD patients. Study 2: A multicenter study of 421 patients introduced to PD from April 2000 to December 2004 in Japan was carried out by the Japanese Society for Elderly Patients on Peritoneal Dialysis to retrospectively analyze patient survival and technique survival and to find factors that have the potential to influence prognosis in these patients. Study 3: A review of the PD management and nursing-care insurance system (long-term care insurance) targeted patients 65 years of age and older who were initiated onto PD from January 2000 to June 2002 at 82 centers in Japan. The review found 765 patients under the age of 65 years (62.6%), and 458 patients 65 years of age and over (37.4%). Data on 409 elderly PD patients from 73 centers were analyzed. ♦ Results Study 1: In 166 elderly patients, 27 (16.3%; 18 women, 9 men) continued PD for more than 5 years at our hospital. The original disease was chronic glomerulonephritis in 21 patients, diabetic nephropathy in 2 patients, nephrosclerosis in 2 patients, and polycystic kidney disease in 2 patients. The causes of death in the elderly PD patients at our hospital were heart failure (20.3%), cerebrovascular disease (17.7%), myocardial infarction (15.2%), debilitation (12.7%), peritonitis (7.6%), and pneumonia (3.8%). We observed significant differences in ultrafiltration, body weight, sodium, chloride, red blood cells, and hematocrit after using icodextrin in 14 elderly PD patients. Also, use of icodextrin in the daytime helps the family supporting an elderly member on PD by reducing the number of exchanges. Study 2: The average age of 421 patients in 37 hospitals throughout Japan was 76.4 years. Women accounted for 41% of all patients. The average modified (exclusive of factors of aging) Charlson comorbidity index (CCI) was 3.7. The modified CCI was an important factor not only in patient survival but also in technique survival. Patient survival was significantly different for the three modified CCI groups (CCI < 3, 3 ≤ CCI < 5, 5 ≤ CCI). Factors that influenced patient survival included patient choice of modality, modified CCI, exchanges performed by family members, and age at the start of PD. Factors that influenced technique survival included patient choice of modality, modified CCI, and exchanges performed by family members. Age at the start of PD was not a significant factor influencing technique survival. Study 3: Most elderly PD patients were living with family; 7% were living alone. At the start of PD, 24% of elderly PD patients were covered by nursing-care insurance, including 11% of young elderly patients (65 – 74 years of age), 35% of old elderly patients (75 – 84 years of age), and 29% of very old elderly patients (85 years of age or older). Patients 75 years of age or older were covered by nursing-care insurance more frequently than were patients under 75 years of age. Nevertheless, at the start of dialysis, fewer than 10% of elderly patients were using nursing-care insurance for PD. ♦ Conclusions In elderly patients, PD has good outcomes, especially in nondiabetic patients, in patients with few comorbidities, and in patients managing PD by themselves. In introducing dialysis in elderly patients, PD should be the treatment of choice. A more secure support system should be established to allow the elderly to choose PD treatment.

Radical Cystectomy in Elderly Patients

1993 ◽  
Vol 60 (1) ◽  
pp. 19-22
Author(s):  
P. Bassi ◽  
M. Gholam Alipour ◽  
G.L. Drago Ferrante ◽  
N. Piazza ◽  
N. Panza ◽  
...  
Keyword(s):  
Elderly Patients ◽  
Radical Cystectomy ◽  
Urinary Diversion ◽  
Length Of Hospital Stay ◽  
Wound Dehiscence ◽  
The Elderly ◽  
Elderly Group ◽  
Medical Complications ◽  
Control Group ◽  
Pelvic Hematoma

Radical cystectomy is the most common treatment for deeply invasive bladder cancer; due to reported operative risks, concerns have been expressed regarding the suitability of this operation in elderly patients. We reviewed the morbility and mortality rates in 50 patients aged 70 years and over (elderly group), undergoing radical cystectomy and urinary diversion, to verify if this procedure could be considered as initial treatment in older-age patients. The findings were compared with those observed in 50 patients aged 40 to 69 years (control group). In the elderly group there was no operative mortality; however 2 patients (4%) died post-operatively due to pulmonary embolism and multi-organ-failure syndrome respectively. Four patients (8%) were re-operated due to intestinal obstruction (2 pts), pelvic hematoma (1 pt) and wound dehiscence (1 pt). Wound separation was the more frequent complication (15%); 6% of patients experienced extended intestinal atonia. The length of hospital stay was 17.1 days. In the control group, surgical complications were comparable to those observed in the elderly group: furthermore medical complications were more frequent. In conclusion, these data suggest that radical cystectomy and urinary diversion can be safely performed in the elderly. Radical surgery is an effective treatment modality for elderly individuals who are in reasonably good general health. A higher incidence of medical complications must be expected in elderly patients.

scholarly journals Five-year experience of continuous ambulatory peritoneal dialysis in children: a single center experience in a developing country

2019 ◽  
Vol 28 (4) ◽  
pp. 329-37 ◽  
Author(s):  
Cahyani Gita Ambarsari ◽  
Partini Pudjiastuti Trihono ◽  
Agustina Kadaristiana ◽  
Taralan Tambunan ◽  
Lily Mushahar ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
Continuous Ambulatory Peritoneal Dialysis ◽  
Patient Survival ◽  
Survival Rates ◽  
Published Data ◽  
Hospital Data ◽  
Technique Survival ◽  
Single Center Experience ◽  
Number Of Patients ◽  
Stage Renal Disease

BACKGROUND The pediatric peritoneal dialysis (PD) program in Cipto Mangunkusumo Hospital, Indonesia was started in 2014. However, there has been no published data on the patients’ outcome. This study was aimed to report the characteristics and outcomes of a continuous ambulatory peritoneal dialysis (CAPD) program for children. METHODS This retrospective study was conducted in Cipto Mangunkusumo Hospital as a national referral hospital. Data were collected from medical records of patients aged ≤18 years with end-stage renal disease who underwent CAPD in 2014–2019. The baseline characteristics, PD-related infection rate, as well as patient and technique survivals were analyzed. RESULTS Out of 60 patients who underwent CAPD, 36 (60%) were boys on the age range of 4 months–18 years. The mean follow-up duration was 12 (95% confidence interval [CI] = 9.4–15.3) months. The number of PD related infections increased along with the growing number of patients on CAPD. The peritonitis rate was 0.42 episodes per year at risk, and the most common etiology was alpha-hemolytic Streptococcus (5/24, [20.8%]). The 1- and 3-year technique survival rates were 60.3% (95% CI = 44.5–72.9) and 43.9% (95% CI = 23.2–62.9). The 1- and 3-year patient survival rates were 69.6% (95% CI = 52.5–81.5) and 58% (95% CI = 31.2–77.5). CONCLUSIONS In this unit, CAPD could be performed in children as young as 4 months of age. The peritonitis rate was relatively low which was likely caused by skin-derived microorganisms. Both technique survival and patient survival were also relatively low.

scholarly journals Prehabilitation Program in Elderly Patients: A Prospective Cohort Study of Patients Followed Up Postoperatively for Up to 6 Months

2021 ◽  
Vol 10 (19) ◽  
pp. 4500
Author(s):  
Claire Malot ◽  
Astrid Durand-Bouteau ◽  
Nicolas Barizien ◽  
Antoine Bizard ◽  
Titouan Kennel ◽  
...  
Keyword(s):  
Cohort Study ◽  
Elderly Patients ◽  
The Elderly ◽  
Elderly Group ◽  
Control Group ◽  
Functional Capabilities ◽  
Observational Cohort ◽  
6 Minute Walk Test ◽  
The Impact ◽  
Minute Walk

The preoperative period may be an opportune period to optimize patients’ physical condition with a multimodal preoperative program. The impact of a “prehabilitation” program on elderly patients is discussed. This mono-center observational cohort study included consecutively 139 patients planned for major abdominal and thoracic surgery, with 44 in the control group (age < 65) and 95 in the elderly group (age > 65). All patients followed a “prehabilitation” program including exercise training, nutritional optimization, psychological support, and behavioral change. Seventeen patients in the control group and 45 in the elderly group completed the study at six months. The 6-minute walk test (6 MWT) increased in both groups from the initial evaluation to the last (median value of 80 m (interquartile range 51) for those under 65 years; 59 m (34) for the elderly group; p = 0.114). The 6 MWT was also similar after one month of prehabilitation for both populations. The rate of postoperative complications was similar in the two groups. Prehabilitation showed equivalence in patients over 65 years of age compared to younger patients in terms of increase in functional capabilities and of postoperative evolution. This multimodal program represents a bundle of care that can benefit a frailer population.

Assessment of Influence of Smoking, Drinking, Leukoplakia and Dental Irritation on Local Control of Early Oral Tongue Carcinoma Treated with Brachytherapy: Age and Dental Factors are Potential Prognostic Factors

2009 ◽  
Vol 95 (4) ◽  
pp. 461-466 ◽  
Author(s):  
Hideya Yamazaki ◽  
Takehiro Inoue ◽  
Ken Yoshida ◽  
Tadayuki Kotsuma ◽  
Yasuo Yoshioka ◽  
...  
Keyword(s):  
Prognostic Factors ◽  
Elderly Patients ◽  
Local Control ◽  
Tongue Cancer ◽  
The Elderly ◽  
Local Control Rate ◽  
Factor Group ◽  
Elderly Group ◽  
Control Group ◽  
Oral Tongue

Background To examine the background characteristics of elderly patients (65 years or older) with node-negative mobile tongue cancer (T1-2N0M0) who showed worse local control than a younger group. Materials and methods We retrospectively analyzed background data for 265 patients treated with brachytherapy with or without external radiotherapy between 1967 and 1999. We examined dental factors (such as irritation by prosthesis), leukoplakia, tobacco smoking and alcohol consumption for comparisons between the elderly (age ≥65 years; n = 83) and a control group (64 years or younger; n = 182). Results The elderly patients showed a worse outcome than the control group (respectively 86% and 70% at 5 years; P <0.05). Incidence of dental factors tended to be higher for elderly patients (53%) than the control group (40%, P = 0.07). Dental factors proved to have prognostic importance for local control. Five-year local control rate was 85% for patients with and 76% for patients without dental factors (P = 0.04). The elderly group positive for dental factors showed a lower 5-year local control rate (61%) than the other three groups [(elderly without the dental factor (–) group (80%), control with the dental factor (+) group (84%), and control without the dental factor (–) group (87%)] (P <0.05). Leukoplakia was found more frequently in the control (23%) than in the elderly group (5%) (P = 0.006) but had no effect on treatment outcome. Conclusions Age and dental factors (including prosthesis irritation) are potentially important prognostic factors for local control of oral tongue cancer treated with brachytherapy, especially for elderly patients.

Assisted Peritoneal Dialysis. Experience in a French Renal Department

2006 ◽  
Vol 26 (6) ◽  
pp. 671-676 ◽  
Author(s):  
Thierry Lobbedez ◽  
Raluca Moldovan ◽  
Marie Lecame ◽  
Bruno Hurault de Ligny ◽  
Wael El Haggan ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
Patient Survival ◽  
Self Care ◽  
Dialysis Patients ◽  
Actuarial Survival ◽  
Technique Survival ◽  
Comorbidity Index ◽  
The Impact ◽  
Home Nurse ◽  
Assisted Peritoneal Dialysis

Background The French healthcare system offers the possibility of increasing the use of peritoneal dialysis (PD) by involving in patient care nurses who work in the private system. Objective This study was conducted to evaluate the impact of a private home-nurse network on one dialysis program. Methods This was a retrospective study of 239 dialysis patients who started dialysis in our center between 1 January 1998 and 31 December 2003. Results Of these 239 patients, 142 were treated with hemodialysis and 97 with PD during the study period. Among the PD patients, 36 of 97 were treated with assisted PD and 61 of 97 with self-care PD. Assisted-PD patients were older (74 ± 10 vs 52 ± 18 years, p < 0.001) and presented more comorbidity (Charlson Comorbidity Index 7 ± 2.5 vs 4.3 ± 2.4, p < 0.05) compared with self-care patients. Continuous ambulatory PD was the modality of choice in the assisted group (32/36). Assisted patients were frequently hospitalized (31/36); actuarial survival free of hospitalization at 6 months was 46%. Patients with nurse assistance had a high risk of peritonitis (actuarial survival free of peritonitis: 52% at 1 year). Technique survival was 85% at 6 months and 58% at 1 year. Actuarial patient survival was 90% at 6 months and 83% at 1 year. Conclusion Assisted PD enables increased use of PD in incident dialysis patients. However, in view of the comorbidities of the assisted-PD patients, the need for frequent hospitalization has to be taken into account in such a program.

scholarly journals Radiotherapy for Elderly Patients Aged ≥75 Years with Clinically Localized Prostate Cancer—Is There a Role of Brachytherapy?

2018 ◽  
Vol 7 (11) ◽  
pp. 424 ◽  
Author(s):  
Hideya Yamazaki ◽  
Koji Masui ◽  
Gen Suzuki ◽  
Satoaki Nakamura ◽  
Norihiro Aibe ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Elderly Patients ◽  
Risk Group ◽  
The Elderly ◽  
Elderly Group ◽  
Localized Prostate Cancer ◽  
Control Group ◽  
Healthy Elderly ◽  
Gu Toxicity

We compared radiotherapy outcomes between 241 elderly patients aged ≥75 years and 867 younger controls (age <75 years) with clinically localized prostate cancer. The elderly group showed an equivalent actuarial seven-year biochemical failure-free survival rate (7y-bNED) (94.9%) to the younger control group (96.4%, p = 0.593). The incidence of late genitourinary (GU) and gastrointestinal (GI) toxicities grade ≥2 was also similar between the elderly and younger cohorts, while no grade ≥4 adverse events occurred. We also examined the role of brachytherapy (BT) in the elderly group, in comparison with image-guided intensity-modulated radiotherapy (IG-IMRT). BT showed superior 7y-bNED (94.1%) than IG-IMRT (84.6%, p = 0.0183) in elderly patients, which was 100% (100% for BT and 100% for IG-IMRT, p > 0.999) for the low-risk group, 94.6% (92.8% and 100%, p = 0.203) for the intermediate-risk group, and 80.5% (91.2% and 73.6%, p = 0.0195) for the high-risk group. BT showed higher GU toxicity and equivalent GI toxicity to IG-IMRT. In conclusion, elderly patients showed bNED and toxicity that were equivalent to those observed in younger controls, and BT is a plausible option also for healthy elderly with potential to improve bNED, with higher but acceptable GU toxicity.

scholarly journals Impact of Dialysis Adequacy on the Mortality and Morbidity of Anuric Chinese Patients Receiving Continuous Ambulatory Peritoneal Dialysis

2001 ◽  
Vol 12 (2) ◽  
pp. 355-360 ◽  
Author(s):  
CHEUK-CHUN SZETO ◽  
TERESA YUK-HWA WONG ◽  
KAI-MING CHOW ◽  
CHI-BON LEUNG ◽  
MAN-CHING LAW ◽  
...  
Keyword(s):  
Renal Function ◽  
Peritoneal Dialysis ◽  
Serum Albumin ◽  
Continuous Ambulatory Peritoneal Dialysis ◽  
Patient Survival ◽  
Residual Renal Function ◽  
The Body ◽  
Chinese Patients ◽  
Dialysis Adequacy ◽  
Technique Survival

Abstract. Dialysis adequacy has a major impact on the outcome of continuous ambulatory peritoneal dialysis (CAPD) patients. However, most studies on peritoneal dialysis adequacy have focused on patients with significant residual renal function. The present study examined the effect of dialysis adequacy on anuric CAPD patients. A single-center prospective observational study on 140 anuric CAPD patients was performed. These patients were followed for 22.0 ± 11.9 mo. Dialysis adequacy and nutritional indices, including Kt/V, creatinine clearance (CCr), protein equivalent nitrogen appearance, percentage of lean body mass, and serum albumin level were monitored. Clinical outcomes included actuarial patient survival, technique survival, and duration of hospitalization. In the study population, 64 were male, 36 (25.7%) were diabetic, and 59 (42.1%) were treated with 6 L exchanges per day. The body weight was 59.2 ± 10.2 kg. Average Kt/V was 1.72 ± 0.31, and CCr was 43.7 ± 11.5 L/wk per 1.73m2. Two-yr patient survival was 68.8%, and technique survival was 61.4%. Multivariate analysis showed that DM, duration of dialysis before enrollment, serum albumin, and index of dialysis adequacy (Kt/V or CCr) were independent factors of both patient survival and technique survival. It was estimated that for two patients who differed only in weekly Kt/V, a 0.1 higher value was associated with a 6% decrease in the RR of death (P < 0.05; 95% confidence interval, 0.92 to 0.99). Serum albumin and CCr were the only independent factors that predicted hospitalization. It was found that even when there is no residual renal function, higher dialysis dosage is associated with better actuarial patient survival, better technique survival, and shorter hospitalization. Dialysis adequacy has a significant impact on the clinical outcome of CAPD patients, and the beneficial effect is preserved in anuric patients as well as in an ethnic group that has a low overall mortality.

scholarly journals Comparison of Survival Between Assisted Peritoneal Dialysis and Self-Care Peritoneal Dialysis Patients Aged 70 or Older

2021 ◽  
Author(s):  
Qianhui Song ◽  
Hao Yan ◽  
Zanzhe Yu ◽  
Zhenyuan Li ◽  
Jiangzi Yuan ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
Older Patients ◽  
Patient Survival ◽  
Cox Model ◽  
Multivariable Analysis ◽  
Self Care ◽  
Free Survival ◽  
Significant Difference ◽  
Esrd Patients ◽  
Technique Failure

Abstract Introduction: Assisted PD is used as an alternative option for the growing group of frail, older ESRD patients unable to perform their own PD. This study was undertaken to investigate the outcomes of assisted PD in older patients by comparing assisted PD patients with self-care PD patients. Methods This study included all patients aged 70 or older who started on PD in our hospital from 2009 to 2018. Patients were divided into assisted PD group and self-care PD group according to the independence of bag exchange, and followed up until death, PD cessation or to the end of the study (December 31, 2019). Survival curves were generated using the Kaplan-Meier method and risk factors associated with mortality, peritonitis and technique failure were evaluated using both cause-specific hazards and subdistribution hazards models. Results 180 patients were enrolled, including 106 (58.9%) males with a median age of 77.5 (77.2–81.2) years. Among the 180 patients, 62 patients (34.4%) were assisted. Patients in the assisted PD group were older, more likely to be female, more prevalent in DM and CVD, with a higher Charlson score than patients in the self-care PD group (P all < 0.05). In the multivariable analysis, assisted patients had a comparable patient survival and peritonitis-free survival compared to self-care PD patients either in the Cox or in the FG models. According to a Cox model, the use of assisted PD was associated with a lower risk of technique failure (cs-HR 0.20, 95% CI 0.04–0.76), but the association lost its statistical significance in the Fine and Gray model. Conclusions No significant difference in patient survival and peritonitis-free survival were found between the assisted PD patients and self-care PD patients. Moreover, assisted PD might protect older patients incapable of self-care from technique failure. Therefore, we suggested that assisted PD could be a safe and effective RRT modality for older ESRD patients who need assistance.

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