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<p>Advances in dialysis therapy and population aging have increased both the age at dialysis initiation and the duration of treatment. This has resulted in a growing population of elderly patients undergoing peritoneal dialysis (PD). PD is often considered a suitable home-based kidney replacement therapy for older adults. However, elderly patients undergoing PD frequently experience complex clinical conditions, including frailty, sarcopenia, nutritional impairment, and chronic inflammation. These conditions are associated with reduced quality of life (QOL), functional decline, and adverse outcomes, such as hospitalization, cardiovascular events, and mortality. Therefore, nutritional impairment is an important yet often overlooked clinical problem in this population. This review summarizes the current evidence on the characteristics, assessment, and management of nutritional impairment in elderly patients receiving PD. We discuss available screening and assessment tools, including serum biomarkers, composite nutritional indices, body composition analysis, and the Global Leadership Initiative on Malnutrition (GLIM) criteria. We also highlight their clinical applicability and limitations in elderly PD populations. Additionally, we review evidence regarding energy and protein requirements, dietary patterns, oral nutritional supplementation, protein supplementation, and combined nutritional and exercise interventions, paying particular attention to sarcopenia and frailty. Although high-quality data specific to elderly and frail PD patients remain limited, emerging evidence suggests that early screening, long-term individualized nutritional interventions, and preservation of residual kidney function may support nutritional and functional management. We propose a practical, stepwise approach to nutritional management based on multidisciplinary care that emphasizes patient-centered outcomes and QOL rather than life prolongation alone. Further prospective and randomized studies are needed to establish optimal strategies for this growing population.</p>

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Recent advances in nutritional care in elderly patients on peritoneal dialysis

  • 期刊论文

  • 出版模式：

    开放获取

  • 发表日期：

    2026年7月9日

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  • Katsuomi Matsui,
  • Tsutomu Sakurada,
  • Etsuko Doi,
  • Akihiko Kato

摘要

Advances in dialysis therapy and population aging have increased both the age at dialysis initiation and the duration of treatment. This has resulted in a growing population of elderly patients undergoing peritoneal dialysis (PD). PD is often considered a suitable home-based kidney replacement therapy for older adults. However, elderly patients undergoing PD frequently experience complex clinical conditions, including frailty, sarcopenia, nutritional impairment, and chronic inflammation. These conditions are associated with reduced quality of life (QOL), functional decline, and adverse outcomes, such as hospitalization, cardiovascular events, and mortality. Therefore, nutritional impairment is an important yet often overlooked clinical problem in this population. This review summarizes the current evidence on the characteristics, assessment, and management of nutritional impairment in elderly patients receiving PD. We discuss available screening and assessment tools, including serum biomarkers, composite nutritional indices, body composition analysis, and the Global Leadership Initiative on Malnutrition (GLIM) criteria. We also highlight their clinical applicability and limitations in elderly PD populations. Additionally, we review evidence regarding energy and protein requirements, dietary patterns, oral nutritional supplementation, protein supplementation, and combined nutritional and exercise interventions, paying particular attention to sarcopenia and frailty. Although high-quality data specific to elderly and frail PD patients remain limited, emerging evidence suggests that early screening, long-term individualized nutritional interventions, and preservation of residual kidney function may support nutritional and functional management. We propose a practical, stepwise approach to nutritional management based on multidisciplinary care that emphasizes patient-centered outcomes and QOL rather than life prolongation alone. Further prospective and randomized studies are needed to establish optimal strategies for this growing population.