Análisis de fragilidad y riesgo de peritonitis en pacientes ancianos en diálisis peritoneal

espanolIntroduccion: Los pacientes ancianos en dialisis peritoneal tienen mayor riesgo de presentar fragilidad, perdida de autonomia, comorbilidad y disminucion de calidad de vida. Objetivo: evaluar la fragilidad, dependencia, depresion y calidad de vida, analizando la repercusion de la fragilidad sobre el tiempo de aprendizaje de la tecnica y la aparicion del primer episodio de peritonitis. Material y Metodo: estudio descriptivo retrospectivo. Se incluyeron pacientes mayores de 70 anos, desde septiembre 2016 a 2017, las peritonitis hasta final de 2018. Se estudiaron variables demograficas, modalidad dialitica, indices de Charlson, Barthel y escala de depresion de Yesavage Escala de fragilidad clinica, calidad de vida, tiempo de entrenamiento y primera peritonitis. Resultados: Se incluyeron 25 pacientes, 56% hombres, edad media 76,77±5,34 anos, el 72% estaban en dialisis peritoneal manual. La media del Charlson 7,88±2,06, del Barthel 88,27±24,66 y del Short form 12 health survey 32,96±8,61. El 40% tenian algun grado de fragilidad, 24% depresion, el 28% precisaban ayuda o estaban institucionalizados. Tiempo medio de entrenamiento en pacientes fragiles fue 16,77±7,93 horas vs no fragiles 15,20±5,06 (p=0,42). Se recogieron 16 episodios de peritonitis, repartidos al 50%, tiempo medio de aparicion fragiles 315,13±212,73 dias vs no fragiles 320,25±224,91 (p=0,44). Conclusiones: La mayoria de los pacientes realizan dialisis peritoneal manual de forma autonoma. Tienen un nivel de fragilidad bajo, no presentan depresion y gozan de buena calidad de vida para su edad. No existe diferencia en el tiempo de aprendizaje entre los dos grupos. Las peritonitis se reparten al 50% en fragiles y no fragiles. EnglishIntroduction: Elderly patients on peritoneal dialysis have a higher risk of presenting fragility, loss of autonomy, comorbidity and decreased quality of life. Objective: To assess frailty, dependency, depression and quality of life, analysing the repercussion of frailty on the learning time of the technique and the appearance of the first episode of peritonitis. Material and Method: descriptive retrospective study. Patients older than 70 years were included, from September 2016 to 2017, episodes of peritonitis until the end of 2018. Demographic variables, dialysis modality, Charlson index, Barthel index, Yesavage geriatric depression scale, clinical fragility scale, quality of life scale, training time and first peritonitis were collected. Results: 25 patients were included, 56% men, mean age 76.77±5.34 years, 72% were on manual peritoneal dialysis. The mean value for the Charlson index was 7.88±2.06, for Barthel index 88.27±24.66 and for the Short form 12 health survey 32.96±8.61. 40% had some degree of frailty, 24% depression, 28% needed help or were institutionalized. Average training time in fragile patients was 16.77±7.93 hours versus nonfragile 15.20±5.06 (p=0.42). 16 episodes of peritonitis were collected, distributed to 50% between both groups. The mean time of appearance of fragile people was 315.13±212.73 days versus 320.25±224.91 days for non-fragile ones (p=0.44). Conclusions: Most of the patients perform manual peritoneal dialysis autonomously. They have low frailty levels, no depression and enjoy a good quality of life for their age. There is no difference in learning time between the two groups. Peritonitis is equally distributed in fragile and non-fragile patients.