Evaluation of complications in urgent start peritoneal dialysis: Single-center experience.

BACKGROUND: Patients who were urgent start peritoneal dialysis (USPD) were evaluated in terms of complications. METHODS: The data from 102 patients (43 males and 59 females, mean age 58.18 ± 15.3 years) who were on peritoneal dialysis with a placed catheter between January 2014 and June 2019 in our Nephrology clinic was evaluated. The patients were divided into three groups according to the starting time of peritoneal dialysis. The development of complications between the groups (peritonitis, leakage, hernia), hemodialysis return time and overall survival times were compared. RESULTS: There was no difference between the groups in terms of survival and complications. Diabetes, advanced age, albumin values were found to be risk factors for mortality, while no differences were found between the groups in terms of complications and mortality. CONCLUSION: USPD can be recommended for both because it provides a permanent dialysis option and because it leads to fewer complications than urgent start HD.

Age is not a risk factor in survival of severely ill patients with co-morbidities in a medical intensive care unit.

BACKGROUND: The individuals over 65 years old constitute an important patient population of medical intensive care units (ICUs). AIM: To evaluate the risk factors for mortality in a medical ICU consisting a group of patients with a large number of co-morbidities. METHODS: This is a retrospective study involving patients who were followed for more than 48 h. The cohort was divided into two groups according to age: (1) young, < 65 years old, and (2) elderly, ≥ 65 years old. RESULTS: A total of 693 patients (303 F, 390 M) were included. The median age was 68 years (18-97). There were 279 (40.3%) young and 414 (59.7%) elderly patients. There was no difference between the groups in gender and mortality (p = 0.436, p = 0.932, respectively). Most of the co-morbid diseases were more common in the elderly except solid malignancies which were more common in young patients (p = 0.033). Long ICU stay, long hospital stay before ICU, high APACHE II and Charlson co-morbidity index scores, pneumonia, acute hepatic failure/coma, malignancy, acute hemodialysis, need for vasopressors, and invasive mechanical ventilation were independent predictors of ICU mortality. CONCLUSION: Age and gender were not found to be predictors of mortality. There was no survival advantage between young and elderly patients. Co-morbid diseases, apart from malignancy, had no effect on mortality. In developing countries, where patients with terminal illness and multiple co-morbid diseases are treated in the ICU, age should not be a determining factor in patient selection for ICU or in the treatment decisions to be applied to patients.