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논문분류	춘계학술대회 초록집
제목	Long-Term Outcomes of Elderly Patients on Peritoneal Dialysis: Divergent Effects of Age on Mortality and Technique Survival Over 20 Years
저자	Ji Hwan Kim
출판정보	2026; 2026(1):
키워드	Peritoneal dialysis, Technique failure, Elderly
초록	Objectives: As the global population ages, dialysis demand among elderly patients is rising. While hemodialysis is predominant, peritoneal dialysis (PD) is a viable home-based alternative. However, evidence regarding long-term technique survival in older PD patients remains limited. This study evaluates the 20-year long-term impact of age on mortality and technique outcomes. Methods: This retrospective cohort study included 436 incident PD patients treated between 2005 and 2025, categorized into three age groups: <65, 65–69, and ≥70 years. All-cause mortality was analyzed using Cox proportional hazards models. Technique failure was evaluated using Fine–Gray competing-risk regression, accounting for kidney transplantation and death as competing events. Results: The mean age at PD initiation was 53.1 years, with 20.4% (n=89) aged ≥65 years and 7.6% (n=33) aged ≥70 years. Over a median follow-up of 37.0 months, 76 deaths (17.4%) and 123 technique failures (28.2%) occurred. Mortality rates rose significantly from 3.01 (<65 years) to 10.3 (≥65 years) per 100 person-years. Adjusted Cox models showed age was strongly associated with mortality (HR 2.03 for 65–69 years; HR 4.88 for ≥70 years). In contrast, competing-risk analyses revealed that advanced age did not independently predict technique failure (sHR 1.26 for 65–69 years; sHR 0.88 for ≥70 years). Instead, the principal determinants of technique failure were lower albumin levels (HR 3.15) and a higher inflammatory burden (hs-CRP, HR 1.11). Conclusion: Although advanced age significantly increases mortality risk in PD patients, it does not independently compromise technique survival when competing risks are properly considered. Therefore, chronological age alone should not preclude PD selection; rather, biological vulnerability is a dominant factor in determining technique sustainability.
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