With aging population and the increasing of the elderly patients with End Stage Renal Failure (ESRF), the population of the elder on dialysis is rising
rapidly worldwide. Choosing dialysis method becomes the primary issues for the
elder with End Stage Renal Failure. Peritoneal dialysis as an important
dialysis, it has both advantages and disadvantages for elderly patients.
1. Advantages
As many elderly patients with End Stage Renal Failure are also accompanied
with Diabetes and other diseases, especially cardiovascular diseases such as
high blood pressure, ischemic heart disease, arrhythmia, acute myocardial
infarction and so on. Compared with hemodialysis, peritoneal dialysis only has
less influence on patients on peritoneal dialysis. Even for the elderly
patients, it usually does not induce arrhythmia, hypotension or aggravate heart
ischemia. Therefore, for the elderly patients with poor tolerance to
hemodialysis or serious blood vessel diseases, peritoneal dialysis is safer to
them. Moreover, the patients on peritoneal dialysis are able to get a better
control of blood pressure and keep the water and electrolyte balance more
effectively. For patients with Diabetic Nephropathy, they can put insulin in
their peritoneal cavity so as to get a better control of their blood sugar
level.
In addition, peritoneal dialysis has less influence on renal function than
hemodialysis. For those with residual renal function, their urine may decline
rapidly or even totally disappear. However, for patients on peritoneal dialysis,
if they can keep proper dehydration, they will be able to sustain the urine
volume as that before dialysis. Therefore, many scholars usually advocate the
patients with comparatively much renal function to receive peritoneal dialysis.
Also compared with those with hemodialysis, the patients with Chronic Renal
Failure on peritoneal dialysis have less serious anemia. It is because the
patients on hemodialysis loss less blood and also the dialysis can remove the
inhibiting factors of erythropoietin and decrease hemolysis.
2. Disadvantages
For the elders, their peritoneal vascular hardens so the ultrafiltration
volume is difficult to predict and the possibility of solute clearance is bad.
Therefore, it is very likely to induce heart failure. The elderly patients with
Chronic Renal Failure are very likely to have insufficient blood supplement,
especially in the lower limbs. Every day, the patients can lose a large amount
of protein and amino acid, especially for those have peritonitis. For the
elderly patients with Chronic Renal Failure, they have already lost much protein
and other nutrients and also are accompanied with digestive system diseases, it
is very likely to lead to and even aggravate malnutrition. Moreover, the
incidence of hernia, peripheral ascular disease, diverticulosis is high among
the elder on peritoneal dialysis.
As peritoneal dialysis has both advantages and disadvantages, they patients
should think about them firstly and then decide which one is better for them. If
you want to know more specific information about hemodialysis and peritoneal
dialysis, you can email to kidney-treatment@hotmail.com. Maybe an email can change your
life.