Acute Kidney Injury in Elderly Population.


eMediNexus    30 November 2017

The purpose of a new study published in Nephron was to evaluate the epidemiological profile of acute kidney injury AKI in hospitalized elderly patients and the variables associated with renal replacement therapy RRT dependency at discharge after an episode of AKI. In this prospective observational study 286 elderly patients aged 60 years or more and with AKI were recruited from a tertiary care hospital. The results revealed that that the overall hospital mortality was 56.3 . Acute Kidney Injury Network AKIN 3 at the time of admission was significantly higher in patients who underwent RRT. While intrinsic AKI AKIN RRT and increased length of stay in emergency care units ECUs had a considerably higher prevalence among non survivors. On the other hand only renal etiology intrinsic AKI was independently associated with mortality. Moreover 85 of the discharged patients were dialysis free and 36.4 of those who had a previous diagnosis of chronic kidney disease CKD upon admission had a worse renal function. Additionally age AKIN 3 RRT prior history of CKD diabetes mellitus and the number of hemodialysis sessions showed to have an impact on dialysis dependence. Meanwhile 24 of 161 patients who had a dialysis indication were placed on palliative care. From the findings it was concluded that the severity of AKI and the need for RRT were risk factors for mortality and dependence on dialysis. It was speculated that antecedents of CKD were associated with a poor renal outcome following an AKI episode. It was stated that starting RRT had an impact the clinical decision to enroll these patients into palliative care.

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