131 ACUTE KIDNEY INJURY IN THE ELDERLY IN HOSPITAL SELAYANG: EPIDEMIOLOGY AND RISK FACTORS

Abstract

Category: Epidemiology and Outcomes from AKI Presenter: Dr VUI ENG PHUI Keywords: Acute kidney injury; Elderly The aging kidney undergoes important anatomic and physiologic changes that increase the risk of acute kidney injury (AKI) in the elderly. Improvements in life expectancy resulted in aging population in Malaysia. Multiple studies have demonstrated that the elderly are more susceptible to developing AKI but data on elderly Malaysians is lacking. To determine the incidence and risk factors of developing AKI in elderly patients. This single-centre, prospective, observational study was performed on all patients who were admitted from 1st till 31st March 2017. Elderly was defined as individual aged 65 year or more at time of admission while AKI was defined as a raised serum creatinine (SCr) of at least 26.5 umol/L within 48 hours or 1.5 times increment from baseline within 7 days. Laboratory SCr results of all adult patients admitted during the study period were retrieved from the hospital Laboratory Information System (LIS). Demographic, patient characteristics and clinical data were collected for all adult patients. Results were analyzed using SPSS Version 23. Of a total of 4845 adult admissions during the study period, 874 (18.0%) admission involved the elderly. A total of 283 adults had AKI where 126 cases involved the elderly. The incidence rate of AKI among the hospitalized elderly was 14.4% compared to 3.9% in hospitalized adults aged less than 65 (p<0.001). The mean age of elderly AKI was 74.8±6.5 years with a male preponderance [81(64.3%)]. Malay accounted for 55 (43.7%) cases, followed by Chinese 53 (42.1%) and Indian 17 (13.5%). Comorbidities were common with 74(58.7%) having both diabetes mellitus (DM) and hypertension and 35 (27.8%) had chronic kidney diseases (CKD). The mean baseline SCr was 145.6+95.5 ìmol/L. The two most causes of AKI in the elderly were infection (39.7%) and hypovolemia (33.3%) and this is followed by obstructive uropathy (11.1%), cardiac (7.9%) and others (8%). Compared to elderly without AKI, elderly with AKI were older (74.7yrs vs 72.8yrs, p<0.001) and had a longer duration of hospitalization (10.1 days vs 4.5 days; p<0.001) The incidence of AKI in the hospitalized elderly patients was 3.7 times higher than those aged less 65years. More than half of the elderly AKI had both DM and hypertension and a quarter had CKD. Infections and hypovolemia resulted in AKI in 73% of cases. Older age and longer duration of hospitalization appeared to be associated with AKI in the elderly.