Date of Award

11-2019

Document Type

Scholarly Project

Degree Name

Master of Physician Assistant Studies (MPAS)

Department

Physician Assistant Studies

First Advisor

Mindy Staveteig

Keywords

Hemodialysis; Peritoneal Dialysis; Dialysis; End-stage Renal Disease; Morbidity; Mortality; Quality of Life; Elderly

Abstract

The objective of this research and systematic literature review is to determine the dialysis modality of choice for elderly patients with end-stage renal disease. This literature review will compare the outcomes of hemodialysis and peritoneal dialysis, which will be judged by morbidity, mortality, and quality of life. In this review, PubMed, Embase, and DynaMed were searched using a specific set of keywords and mesh headings. Results of the searches were then filtered to include human-only studies, patients over 65 years old, and published within the last ten years. There were 12 studies that met inclusion criteria and were selected for this literature review. The studies suggested that there were similar outcomes in elderly patients receiving hemodialysis and peritoneal dialysis, and it was concluded that dialysis modality selection should be made on an individual patient basis. The choice between hemodialysis and peritoneal dialysis should be made after first considering each patient’s goals of healthcare, co-morbid conditions, and life experiences. The dialysis modalities should be discussed between the provider and the patient in detail, and a joint decision regarding dialysis modality selection can then be made. Lastly, barriers should be identified so that they can be overcome with proper education, counseling, and assistance. These steps will allow the older patient to be successful with their selected dialysis modality.

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