Abstract
BackgroundAlthough aging increases susceptibility to acute kidney injury (AKI), whether the AKI risk and the association between AKI and adverse outcomes are age-dependent remain unclear in older adults. The current study aimed to identify whether AKI risk was age-dependent in older adults and to investigate whether the association between AKI and mortality increased with increasing age.MethodsMedical records from 47,012 adult hospital admissions, including 30,194 older adults aged 60 or older, in two tertiary general hospitals were studied retrospectively. AKI was identified based on changes in blood creatinine levels according to the Kidney Disease: Improving Global Outcomes criteria.ResultsAmong the total population and 30,194 older adult patients, the raw incidences of AKI were 8.2 and 8.3%, respectively. The curve of the age-grouped AKI incidence was “U-shaped”, which revealed a positive relationship between the AKI incidence and age among the older adults aged 75 years or older. This trend of the age-AKI relationship was supported by further multivariable analysis. After adjusting for the Charlson Comorbidity Index score, the AKI was associated with in-hospital mortality; however, the associations did not increase with increasing age.ConclusionThe AKI risk does not increase with age in older adults, except for those aged 75 and above. The association between AKI and in-hospital death did not increase in an age-dependent manner in older adults.Trial registrationThis study was retrospectively registered at clinicaltrials.gov (NCT03054142) on February 13, 2017.
Highlights
Aging increases susceptibility to acute kidney injury (AKI), whether the AKI risk and the association between AKI and adverse outcomes are age-dependent remain unclear in older adults
We investigated whether the AKI risk was age-dependent in older adults and explored whether the association between AKI and mortality increased with increasing age
Relationship between age and AKI We investigated the AKI incidence by age subgroup with 5-year intervals
Summary
Aging increases susceptibility to acute kidney injury (AKI), whether the AKI risk and the association between AKI and adverse outcomes are age-dependent remain unclear in older adults. Population aging is an increasing global problem; China’s aging population is increasing rapidly, and in 2016, the number of Chinese people > 65 years soared to 150 million, or 10.8% of the population [1]. This aging population has imposed heavy burdens on healthcare systems and has become a challenge for clinicians. The change in terminology from acute renal failure to AKI reflects the recognition that smaller decreases in kidney function without overt organ failure are of substantial clinical relevance and are associated with increased morbidity and mortality [5]. The clinical characteristics and outcomes have not been well studied in older adults
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