Outcome of peritoneal dialysis and hemodialysis in elderly patients with diabetes: early experience from Bangladesh

Abstract

In the present study, we analyzed the short-term outcome of continuous ambulatory peritoneal dialysis (PD) and hemodialysis (HD) in a group of elderly Bangladeshi patients with diabetes. Over a period of 2 years, we tracked various parameters in 60 patients on maintenance dialysis (25 on PD, 35 on HD). Mean age of the patients was 62 +/- 12 years (PD) and 57 +/- 8 years (HD), p < 0.03. Pre-dialysis systolic blood pressures (SBP) were 156 +/- 12 mmHg and 160 +/- 15 mmHg, and diastolic blood pressures (DBP) were 86 +/- 7 mmHg and 84 +/- 6 mmHg, both p = nonsignificant (NS). Pre-dialysis serum creatinine (SCr) levels were 1036 +/- 139 micromol/L and 1028 +/- 408 micromol/L, and daily urine volumes (UV) were 1.1 -/+ 0.4 L and 1 +/- 0.1 L, both also p=NS. At the end of the 2 years, durations of dialysis were 14 +/- 8 months (PD) and 13 +/- 12 months (HD), p=NS; SBPs were 142 +/- 15 mmHg and 155 +/- 18 mmHg, p < 0.004; DBPs were 81 +/- 6 mmHg and 80 +/- 7 mmHg, p=NS; and SCr levels were 538 +/- 154 micromol/L and 578 +/- 195 micormol/L, p=NS. The daily UVs had declined to 0.7 +/- 0.3 L and 0.3 +/- 0.3 L (p < 0.001) after periods of 12 +/- 7 months and 7 +/- 5 months (p < 0.001) respectively. During the study period, mortality in the PD group was 60% and in the HD group was 43% (p=NS). We conclude that elderly diabetic patients on PD have better control of blood pressure and maintain residual renal function longer than do similar patients on HD; at the same time, mortality in the two groups is comparable.