Peritoneal dialysis is a well accepted home based therapy even in geriatric patients. Geriatric patients are presenting faster transport rates than non-geriatric, apparently related to hypoalbuminemia.
The aim of the study was to evaluate nutritional parameters in non-geriatric and geriatric patients.
We evaluated nutritional parameters at the first peritoneal equilibration test after dialysis start together with clearance data in non-geriatric (age < 75 years) and geriatric patients (age ≥ 75 years). Data of 118 non-geriatric patients (78 male, 40 female) and of 49 geriatric patients (29 male, 20 female) could be acquired. Mann-Whitney test was used for the comparison of groups.
Median age of non-geriatric patients was 63 years, respectively 79 years of geriatric patients. Body mass index was similar (median 25.8 versus 27.0 kg/m2). Geriatric patients showed lower albumin (median 3.3 versus 3.7 g/l, p<0.01), lower normalized protein equivalent of nitrogen appearance (median 0.86 versus 0.98 g/kg/day, p=0.02), lower potassium (median 4.10 versus 4.50 mEq/l, p<0.01), lower phosphorous (median 4.45 versus 5.15 mg/dl, p=0.02, despite lower pill burden), and lower daily fluid removal (urine volume and peritoneal ultrafiltration) (median 1310 versus 1780 ml, p<0.01). Hypoalbuminaemia (<3.5 g/l) was more frequent in geriatric patients (69.4% versus 38.1%). Mean peritoneal protein loss was similar (600 mg/day).
There were no statistical differences regarding C-reactive protein, erythrocyte sedimentation rate, beta 2 microglobulin and haemoglobin. Mean corpuscular volume of erythrocytes was significantly higher in geriatric patients (median 92.2 versus 89.9 fl, p<0.01).
Furthermore there were no statistically significant differences in peritoneal creatinine and urea clearances. Due to lower urinary clearances, geriatric patients showed insignificantly lower total Kt/V and creatinine clearances.
Geriatric patients are presenting signs of reduced protein, potassium, phosphorous and vitamin intake, already during the initial period of peritoneal dialysis. Nutritional counseling and support should be offered prematurely, especially for geriatric patients.
