https://doi.org/10.4081/gc.2026.13963
Clinical outcomes and complication rates of peritoneal dialysis in elderly patients: an 18-year retrospective analysis
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.
Published: 12 March 2026
Peritoneal dialysis (PD) is a gentle, self-managed modality that offers significant benefits for elderly patients with end-stage kidney disease (ESKD), particularly in preserving residual kidney function (RKF). Despite its advantages, PD remains underutilized in this population. This retrospective study evaluated clinical, nutritional, and metabolic outcomes, as well as quality of life, in 164 patients initiating PD, comparing elderly patients (≥65 years, n=22; mean age 71.1±5.5 years) to younger counterparts (<65 years, n=142; mean age 42.8±13.2 years). Parameters were assessed at baseline and after 24 months. Initially, the elderly group had a higher Charlson comorbidity index and lower RKF. Serum creatinine was the only significantly lower marker in older patients, with other metabolic and clearance parameters showing no notable differences. After 24 months, both groups exhibited improved clearance of urea, potassium, and alkaline reserves. In the elderly, serum albumin decreased and triglycerides increased significantly. Complication rates were similar across groups. While not statistically significant, elderly patients showed better technique survival but higher mortality, primarily from cardiovascular causes. These findings suggest that PD is a viable and safe treatment option for elderly ESKD patients, yielding comparable outcomes to younger individuals. However, ongoing monitoring of comorbidities and nutritional status remains crucial to optimize care in this population.
Downloads
Hill NR, Fatoba ST, Oke JL, et al. Global prevalence of chronic kidney disease – a systematic review and meta-analysis. PLoS One 2016;11:e0158765. DOI: https://doi.org/10.1371/journal.pone.0158765
Tang Y, Jiang J, Zhao Y, Du D. Aging and chronic kidney disease: epidemiology, therapy, management and the role of immunity. Clin Kidney J 2024;17:sfae235. DOI: https://doi.org/10.1093/ckj/sfae235
Jiang C, Zheng Q. Outcomes of peritoneal dialysis in elderly vs non-elderly patients: a systemic review and meta-analysis. PLoS One 2022;17:e0263534. DOI: https://doi.org/10.1371/journal.pone.0263534
Merchant AA, Ling E. Approche de traitement des adultes âgés atteints d’insuffisance rénale chronique. CMAJ Can Med Assoc J 2023;195:E936-43. [Article in French]. DOI: https://doi.org/10.1503/cmaj.221427-f
François K, Bargman JM. Evaluating the benefits of home-based peritoneal dialysis. Int J Nephrol Renov Dis 2014;7:447-55. DOI: https://doi.org/10.2147/IJNRD.S50527
Johansen KL, Chertow GM, Gilbertson DT, et al. US renal data system 2021 annual data report: epidemiology of kidney disease in the United States. Am J Kidney Dis 2022;79:A8-12. DOI: https://doi.org/10.1053/j.ajkd.2022.02.001
Li PKT, Chow KM, Cho Y, et al. ISPD peritonitis guideline recommendations: 2022 update on prevention and treatment. Perit Dial Int 2022;42:110-53. DOI: https://doi.org/10.1177/08968608221080586
Moist LM, Fenton S, Kim JS, et al. Canadian Organ Replacement Register (CORR): reflecting the past and embracing the future. Can J Kidney Health Dis 2014;1:26. DOI: https://doi.org/10.1186/s40697-014-0026-5
Bello AK, Okpechi IG, Osman MA, et al. Epidemiology of peritoneal dialysis outcomes. Nat Rev Nephrol 2022;18:779-93. DOI: https://doi.org/10.1038/s41581-022-00623-7
Frindy M, Lahlou L, Saadi A, Razine R. L’insuffisance rénale chronique terminale : mortalité et facteurs de risque dans la région de Rabat, Maroc. Rev Épidémiol Santé Publique 2016;64:S229. DOI: https://doi.org/10.1016/j.respe.2016.06.232
Chiu YW, Jiwakanon S, Lukowsky L, et al. An update on the comparisons of mortality outcomes of hemodialysis and peritoneal dialysis patients. Semin Nephrol 2011;2:152-8. DOI: https://doi.org/10.1016/j.semnephrol.2011.01.004
van de Luijtgaarden MWM, Noordzij M, Stel VS, et al. Effects of comorbid and demographic factors on dialysis modality choice and related patient survival in Europe. Nephrol Dial Transplant 2011;26:2940-7. DOI: https://doi.org/10.1093/ndt/gfq845
Segall L, Nistor I, Van Biesen W, et al. Dialysis modality choice in elderly patients with end-stage renal disease: a narrative review of the available evidence. Nephrol Dial Transplant 2017;32:41-9. DOI: https://doi.org/10.1093/ndt/gfv411
Marturano D, Manani SM, Virzi GM, et al. #4650 evaluation of psychological support in hemodialysis and peritoneal dialysis patients. Nephrol Dial Transplant 2023;38:gfad063d_4650. DOI: https://doi.org/10.1093/ndt/gfad063d_4650
Qiu J, Zhang C, Xie J, et al. Psychological profile of Chinese peritoneal dialysis patients during the Omicron pandemic in 2022. BMC Psychol 2024;12:109. DOI: https://doi.org/10.1186/s40359-024-01615-x
Alfano G, Fontana F, Giovanella S, et al. Prevalence, clinical course and outcomes of COVID-19 in peritoneal dialysis (PD) patients: a single-center experience. Clin Exp Nephrol 2023;27:171-8. DOI: https://doi.org/10.1007/s10157-022-02283-0
Tabuti NIM, Pellizzari C, Carrascossi H, et al. Impact of telemedicine on metabolic control and hospitalization of peritoneal dialysis patients during the COVID-19 pandemic: a national multicentric cohort study. Braz J Nephrol 2022;44:473-81. DOI: https://doi.org/10.1590/2175-8239-jbn-2021-0113
Jiang HJ, Tang H, Xiong F, et al. COVID-19 in peritoneal dialysis patients. Clin J Am Soc Nephrol 2021;16:121-3. DOI: https://doi.org/10.2215/CJN.07200520
Ding X, Wang X, Gremel GW, et al. COVID-19 and hospitalization among maintenance dialysis patients: a retrospective cohort study using time-dependent modeling. Kidney Med 2022;4:100537. DOI: https://doi.org/10.1016/j.xkme.2022.100537
Lano G, Braconnier A, Bataille S, et al. Risk factors for severity of COVID-19 in chronic dialysis patients from a multicentre French cohort. Clin Kidney J 2020;13:878-88. DOI: https://doi.org/10.1093/ckj/sfaa199
Brown EA, Johansson L, Farrington K, et al. Broadening Options for Long-term Dialysis in the Elderly (BOLDE): differences in quality of life on peritoneal dialysis compared to haemodialysis for older patients. Nephrol Dial Transplant 2010;25:3755-63. DOI: https://doi.org/10.1093/ndt/gfq212
Portolés J, Martín L, Broseta JJ, Cases A. Anemia in chronic kidney disease: from pathophysiology and current treatments, to future agents. Front Med 2021;8:642296. DOI: https://doi.org/10.3389/fmed.2021.642296
Wu J, Kong G, Lin Y, et al. Development of a scoring tool for predicting prolonged length of hospital stay in peritoneal dialysis patients through data mining. Ann Transl Med 2020;8:1437. DOI: https://doi.org/10.21037/atm-20-1006
Taveras AE, Bekui AM, Gorban-Brennan N, Raducu R, Finkelstein FO. Peritoneal dialysis in patients 75 years of age and older--a 22-year experience. Adv Perit Dial 2012;28:84-8.
CRediT authorship contribution
Hmaidouch Nabil: conceptualization of the study, data collection, and initial drafting of the manuscript. El Kadiri Nada: data curation, literature review, and critical revision of the text. Ouzeddoun Naima: methodological guidance, supervision, and manuscript review. Benamar Loubna: overall project administration, senior supervision, and final approval of the version to be submitted. All the authors read and approved the final version of the manuscript and agreed to be accountable for all aspects of the work.
How to Cite
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
PAGEPress has chosen to apply the Creative Commons Attribution NonCommercial 4.0 International License (CC BY-NC 4.0) to all manuscripts to be published.