POS-009 PREVALENCE AND ETIOLOGIES OF ACUTE KIDNEY INJURY IN ELDERLY

Abstract

Acute renal failure in the elderly is a common phenomenon. It is favored by functional modifications of the kidney and the repercussions of many chronic diseases such as diabetes, hypertension or obstructive urological pathologies which incidence increases with age. The aim of our work was to study the epidemiological and clinical characteristics, to specify the etiological circumstances and the different therapeutic and evolutionary modalities of AKI in the elderly. It was a retrospective descriptive study conducted on 70 AKI files identified in the Nephrology department of Charles Nicolle Hospital in Tunis among 380 patients hospitalized over a period of one year. The incidence of AKI in the elderly was 44.8%. It was classified AKIN 1, 2 and 3 in 25%, 25.6% and 49.4% of cases, respectively. The average age was 75 years. The sex ratio was 1.12. The pathological history was dominated by cardiovascular pathology. High blood pressure and diabetes were noted in 56% and 32% of the cases, respectively. Patients were hospitalized through the emergency room in 47.1% of the cases or outpatient in 14.3% of the cases. The discovery of AKI was systematic in the face of an increase in serum creatinine and / or urea numbers in 60% of cases. Signs of acute uremia and changes in diuresis revealed ARI in 57.1% and 30% of the cases, respectively. The mean creatinine level was 515 μmol / l. Hypokalemia and hyperkalemia were observed in 14.4% and 21.4% respectively. AKI was organic in 42.8% of the cases, functional in 31.8% of the cases and related to an obstacle in 24.8% of the cases. Correction of hydroelectrolytic disorders was performed in 61.4% of our patients. Diuretics were used in 17.4% of patients. Hemodialysis was performed only in 18% of our patients. It was performed prophylactically in 7 cases and in an emergency context in 6 cases. In the latter case, the indication for hemodialysis was primarily hyperkalemia and / or metabolic acidosis. The average hospital stay was 19 days. The evolution was favorable in 64.2% of the cases, unfavorable in 35.8% of the cases with a passage to chronicity in 32.6% and a death in 12.8% of the cases. In the elderly, acute renal failure is a common morbid event. The structural and functional alterations of the nephron and the increase in the incidence of certain pathologies expose these patients to nephrotoxic accidents. Hence the interest of preventive measures of this AKI and especially the importance of an early diagnosis based on new biomarkers of AKI, in order to establish the most suitable therapeutic means.