| Theme |
Present Status of Peritoneal Dialysis in Japan |
| Title |
Benefits of continuous ambulatory peritoneal dialysis (CAPD) therapy for elderly patients |
| Author |
Hidetomo Nakamoto |
Department of General Internal Medicine, Saitama Medical University |
| Author |
Yuki Shimada |
Department of General Internal Medicine, Saitama Medical University |
| Author |
Hideki Kuniyoshi |
Department of General Internal Medicine, Saitama Medical University |
| Author |
Shunsuke Kinoshita |
Department of General Internal Medicine, Saitama Medical University |
| [ Summary ] |
The number of elderly patients with end-stage renal disease (ESRD) is increasing in Japan. At the end of 2005, the average age of patients who were newly receiving dialysis was 66.2. The majority of these elderly ESRD patients began receiving hemodialysis (over 95 %). However, a small number of these patients received CAPD (less than 3 %). From 2002, an elderly CAPD study group (Society for Senile Patients on Peritoneal Dialysis) was established in Japan to investigate the CAPD conditions for elderly patients. According to the reports from this group, elderly patients have an excellent outcome even with multiple comorbid conditions. CAPD therapy has some advantages, especially for elderly ESRD patients, as compared to hemodialysis. For example, elderly patients with cardiovascular complications will have good prognoses because of minor effects on their homodynamic condition, including blood pressure, systemic volume, and perfusion pressure in coronary and renal arteries. In addition, it is well known that CAPD treatment has a protective effect on the decline of residual renal functions (RRF) and good effects on calorie intake from the CAPD solution.
CAPD is a treatment method that should be considered as the first choice in introducing dialysis therapy for elderly patients. Furthermore, to increase the number of elderly CAPD patients in Japan, it is desirable to establish a more secure back-up system to support elderly CAPD patients. |