Abstract

BackgroundInformation on acute kidney injury (AKI) in elderly hospitalized patients is limited. This study aims to assess the incidence, risk factors and outcomes of AKI in elderly Chinese patients.MethodThe Epidemiology of AKI in Chinese Hospitalized adults (EACH) study is a multicenter, retrospective cohort study conducted in nine regional central hospitals across China. Patients aged more than 65 years were selected from the EACH study for this analysis. A novel approach with adjustment for frequency of serum creatinine was used to estimate the incidence of AKI in elderly patients. In-hospital outcomes, including mortality, renal recovery, length of stay and daily cost of elderly patients, were analyzed and compared with outcomes in younger patients.ResultsOf 144,232 adult patients in the EACH study, 42,737 (29.63 %) patients were 65 years or older, including 9773 very elderly patients (≥80 years old). The incidence of AKI was 15.44 % in patients 65–79 years old (community-acquired (CA) AKI of 3.89 % and hospital-acquired (HA) AKI of 11.55 %) and 22.22 % in the very elderly group (CA-AKI of 6.58 % and HA-AKI of 15.64 %). The mortality rate of AKI was 10.3 % in patients aged from 65 to 80 and 19.6 % in patients older than 80 years. AKI incidence, in-hospital mortality, percentage of patients requiring dialysis and percentage without renal recovery were higher in elderly patients than in younger patients.ConclusionThe incidence of AKI in elderly Chinese hospitalized patients is high, which becomes a substantial burden on medical care in China.

Highlights

  • Information on acute kidney injury (AKI) in elderly hospitalized patients is limited

  • AKI incidence, in-hospital mortality, percentage of patients requiring dialysis and percentage without renal recovery were higher in elderly patients than in younger patients

  • Several singlecenter studies did not adjust the frequency of serum creatinine (SCr) tests, which may have led to underestimation of the incidence of AKI in hospitalized elderly Chinese patients [14, 15]. In this large retrospective cohort study of hospitalized adults in China, we aimed to demonstrate the incidence rate, risk factors and in-hospital outcomes of AKI in elderly patients by using a novel analytical method to minimize the impact of frequency of SCr tests

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Summary

Introduction

Information on acute kidney injury (AKI) in elderly hospitalized patients is limited. This study aims to assess the incidence, risk factors and outcomes of AKI in elderly Chinese patients. Acute kidney injury (AKI) is a common disorder, characterized by an abrupt or rapid decline in renal filtration function. The incidence of dialysis-dependent AKI increased by 10 % every year in the past decade [1]. The incidence of AKI in hospitalized patients varied in different studies, depending on the definition of AKI, frequency of serum creatinine (SCr) tests, clinical setting of study population, and economical level of countries [2,3,4]. In the Epidemiology of AKI in Chinese Hospitalized adults (EACH) study, by using a novel approach. People have aging kidneys undergoing structural and functional changes that decrease auto regulatory capacity and increase susceptibility to damage [7].

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