The Utility of a Structured Evaluation of Elderly Patients for Continuous Peritoneal Dialysis

The elderly comprise an increasing proportion of chronic dialysis patients. Recruiting them for continuous peritoneal dialysis (CPO) would help CPO programs maintain a patient population. We retrospectively studied the ability of a prospective evaluation to predict success with CPO in elderly (age >60 years) patients. PO nurses and a renal social worker assigned scores in 10 categories, which were then averaged to obtain an overall evaluation score. Scores were from 1–5 with 1 = good, 5 = poor, and 3 = average. Thirty-four elderly patients began CPO during the study period. Evaluation scores were available for 28 of these patients before they began dialysis. Evaluation scores <3 predicted success with CPO (2.2:1:0.2 versus 3.2:1:0.4 in patients transferring to hemodialysis, p<0.02). Patient motivation and preference were the categories that predicted success with CPO. Elderly patients were more likely than younger patients (those <60 years of age) to decline CPO for social reasons (46% versus 4% respectively, p<0.001). Elderly patients required more CPO training time than young patients (4.9:1:0.7 days versus 3.3:1:0.8 days respectively, p<0.01). We conclude that a prospective assessment of elderly patients can predict success with CPO and provide information important to individual structuring of CPO training and follow-up.