Delivering Personalized, Goal-Directed Care to Older Patients Receiving Peritoneal Dialysis

Background: An aging population living with chronic kidney disease and progressing to kidney failure, subsequently receiving peritoneal dialysis (PD) is growing. A significant proportion of these patients are also living with multi-morbidities and some degree of frailty. Recent practice recommendations from the International Society of Peritoneal Dialysis advocate for high-quality, goal-directed PD prescription, and the Standardized Outcomes of Nephrology-PD initiative emphasized the need for an individualized, goal-based care approach in all patients receiving PD treatment. In older patients, this approach to PD care is even more important. A frailty screening assessment, followed by a comprehensive geriatric assessment (CGA) prior to PD initiation and when dictated by change in relevant circumstances is paramount in tailoring PD care and prescription according to the needs, life goals, as well as clinical status of older patients with kidney failure. Summary: Our review aimed to summarize the different dimensions to be taken into account when delivering PD care to the older patient – from frailty screening and CGA in older patients receiving PD to employing a personalized, goal-directed PD prescription strategy, to preserving residual kidney function, optimizing blood pressure (BP) control, and managing anemia, to addressing symptom burden, to managing nutritional intake and promoting physical exercise, and to explore telehealth opportunities for the older PD population. Key Messages: What matters most to older PD patients may not be simply extending survival, but more importantly, to be living comfortably on PD treatment with minimal symptom burden in a home environment and to minimize treatment complications.

Standort
Deutsche Nationalbibliothek Frankfurt am Main
Umfang
Online-Ressource
Sprache
Englisch

Erschienen in
Delivering Personalized, Goal-Directed Care to Older Patients Receiving Peritoneal Dialysis ; volume:9 ; number:5 ; year:2023 ; pages:358-370 ; extent:13
Kidney diseases ; 9, Heft 5 (2023), 358-370 (gesamt 13)

Urheber
Wu, Henry H.L.
Poulikakos, Dimitrios
Hurst, Helen
Lewis, David
Chinnadurai, Rajkumar

DOI
10.1159/000531367
URN
urn:nbn:de:101:1-2023101200302242235714
Rechteinformation
Open Access; Der Zugriff auf das Objekt ist unbeschränkt möglich.
Letzte Aktualisierung
14.08.2025, 11:01 MESZ

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Beteiligte

  • Wu, Henry H.L.
  • Poulikakos, Dimitrios
  • Hurst, Helen
  • Lewis, David
  • Chinnadurai, Rajkumar

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