Acute renal failure in the elderly: particular characteristics

Musso, Carlos G.; Liakopoulos, Vassilios; Ioannidis, Iraklis; Eleftheriadis, Theodoros; Stefanidis, Ioannis

doi:10.1007/s11255-006-0084-4

Cited by 40 publications

(27 citation statements)

References 38 publications

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“…However, it does not agree with previous studies on general elderly patients with AKI, which is frequently of multifactorial origin and often with an atypical presentation, which combines the characteristics of prerenal azotemia, ATN, and obstructive AKI. 21 According to the literature, stage 3 (OR=2.57, p=0.027) were identified as the predictors of death in logistic regression analysis (Table 3). Adjusting for variables such as age, sepsis, and APACHE II, there was no significant change in the association between AKI stage 3 and mortality ( Figure 2).…”

Section: Yokota Et Almentioning

confidence: 99%

Acute kidney injury in elderly intensive care patients from a developing country: clinical features and outcome

Yokota¹,

Sampaio²,

Rocha³

et al. 2017

IJNRD

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Aim:The elderly are at high risk of acute kidney injury (AKI) because of structural and functional degeneration over time and with the aging of the population, the demand for intensive care unit (ICU) admission for older patients has risen recently. However, data from developing countries are scarce. This study aimed to describe the incidence of AKI in elderly patients admitted to ICU from a developing country, to determine the most frequent etiologies for renal impairment and identify its risk factors and outcome. Methods: All patients admitted to the ICU at a Brazilian teaching hospital for 12 consecutive months were followed prospectively from the time of admission until ICU discharge. Elderly was defined as aged >60 years and AKI was defined according to the Kidney Disease Improving Global Outcomes 2012 criteria. Multivariable logistic regression was used to adjust confounding and selection bias. Results: Two hundred elderly patients were included in the study. AKI incidence was 27% and the main etiology was sepsis (48.1%). At logistic regression, baseline creatinine (odds ratio [OR]=5.17, p<0.0001), Acute Physiology and Chronic Health Evaluation (APACHE) II (OR=1.20, p<0.0001), sepsis (OR=2.96, p<0.0001), and longer ICU stay (OR=1.68, p<0.0001) were associated with AKI in elderly patients. Baseline creatinine (OR=1.97, p=0.018), APACHE II (OR=1.29, p<0.0001), sepsis (OR=1.87, p<0.0001), and AKI severity (OR=2.57, p=0.027) were identified as predictors of death. Conclusion: AKI was frequent in elderly patients admitted to ICU from a developing country, and it was identified as a risk factor for death. Sepsis was an important risk factor for both AKI and mortality, similar to developed countries and in younger populations.

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Section: Yokota Et Almentioning

confidence: 99%

Acute kidney injury in elderly intensive care patients from a developing country: clinical features and outcome

Yokota¹,

Sampaio²,

Rocha³

et al. 2017

IJNRD

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“…The high serum urea level can be explained by the extensive urea tubular reabsorption induced by volume contraction [5]. However, acute renal failure secondary to dehydration in the elderly usually shows a different serum pattern that consists of an elevation not only of the serum urea level, but also of serum creatinine, and both altered values also normalize with rehydration [6]. Since the latter observation can be explained by a different tubular creatinine handling (i.e., creatinine reabsorption) in elderly compared to young patients, we decided to study prospectively if there is tubular creatinine reabsorption in healthy elderly people.…”

Section: Introductionmentioning

confidence: 99%

Creatinine reabsorption by the aged kidney

et al. 2008

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“…Nevertheless, inability to conserve sodium may predispose the elderly to hemodynamic instability in the setting of sodium loss [81]. This, along with other structural and functional changes, makes elderly more prone to develop acute kidney injury [82].…”

Section: Fluid and Electrolyte Balancementioning

confidence: 99%

Renal senescence in 2008: progress and challenges

et al. 2008

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Kidneys are significantly affected by profound anatomic and functional changes with senescence. These changes lead to decline in glomerular filtration rate, decreased urinary concentrating and diluting ability, diminished urinary acidification, and impaired potassium clearance, to list a few. Such changes make the elderly prone to drug toxicity and serious fluid and electrolyte imbalance. While the entire mystery of aging is far from being clear, the role of oxidative stress, telomere length, Klotho gene expression, and the renin angiotensin system seem to be the key mechanisms involved in aging. Aging, being a complex process, involves an array of intertwined molecular pathways. Simultaneous study of multiple molecular pathways in parallel could provide invaluable information in understanding the clinical course of kidney aging and elucidating mechanisms that play key roles in the aging process. A better understanding of these mechanisms may help to preserve renal function, improve morbidity and mortality, and hopefully reduce healthcare costs for the aging population.

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Acute renal failure in the elderly: particular characteristics

Cited by 40 publications

References 38 publications

Acute kidney injury in elderly intensive care patients from a developing country: clinical features and outcome

Acute kidney injury in elderly intensive care patients from a developing country: clinical features and outcome

Creatinine reabsorption by the aged kidney

Renal senescence in 2008: progress and challenges

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