Abstract
Background Aging is associated with a high risk of acute kidney injury (AKI), and the elderly with AKI show a higher mortality rate than those without AKI. In this study, we compared AKI outcomes between elderly and nonelderly patients in a university hospital in a developing country. Materials and Methods This retrospective cohort study included patients with AKI who were admitted to the medical intensive care unit (ICU) between January 1, 2012, and December 31, 2017. The patients were divided into the elderly (eAKI; age ≥65 years; n = 158) and nonelderly (nAKI; n = 142) groups. Baseline characteristics, comorbidities, principle diagnosis, renal replacement therapy (RRT) requirement, hospital course, and in-hospital mortality were recorded. The primary outcome was in-hospital mortality. Results The eAKI group included more females, patients with higher Acute Physiology and Chronic Health Evaluation II scores, and patients with more comorbidities than the nAKI group. The etiology and staging of AKI were similar between the two groups. There were no significant differences in in-hospital mortality (p=0.338) and RRT requirement (p=0.802) between the two groups. After adjusting for covariates, the 28-day mortality rate was similar between the two groups (p=0.654), but the 28-day RRT requirement was higher in the eAKI group than in the nAKI group (p=0.042). Conclusion Elderly and nonelderly ICU patients showed similar survival outcomes of AKI, although the elderly were at a higher risk of requiring RRT.
Highlights
Aging is associated with a high risk of acute kidney injury (AKI), and the elderly with AKI show a higher mortality rate than those without AKI
Materials and Methods. is retrospective cohort study included patients with AKI who were admitted to the medical intensive care unit (ICU) between January 1, 2012, and December 31, 2017. e patients were divided into the elderly and nonelderly groups
Results. e eAKI group included more females, patients with higher Acute Physiology and Chronic Health Evaluation II scores, and patients with more comorbidities than the nAKI group. e etiology and staging of AKI were similar between the two groups. ere were no significant differences in in-hospital mortality (p 0.338) and renal replacement therapy (RRT) requirement (p 0.802) between the two groups
Summary
Aging can negatively affect the ability to protect against cellular injuries and impair repair processes, resulting in poor outcomes among elderly patients. Individuals are susceptible to AKI, when critically ill [3, 4]. Is can be attributed to comorbidities, increased severity of acute illnesses, polypharmacy, need for invasive procedures, and age-dependent changes in this population [5,6,7]. In case of the scarcity of resources, such as in developing countries, critically ill elderly patients with AKI may be treated with less intensive care to spare resources for young patients. Erefore, the present study aimed to compare the in-hospital outcomes of elderly and nonelderly patients with AKI admitted to the medical intensive care unit (ICU) of a university hospital in a developing country In case of the scarcity of resources, such as in developing countries, critically ill elderly patients with AKI may be treated with less intensive care to spare resources for young patients. erefore, the present study aimed to compare the in-hospital outcomes of elderly and nonelderly patients with AKI admitted to the medical intensive care unit (ICU) of a university hospital in a developing country
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