Quality of Life, Functional Status, and Specific Medical Problems in Older Patients

Abstract

For older patients burdened by acute kidney injury (AKI)- or chronic kidney disease (CKD)-related comorbidities, quality of life is frequently reported to be of more importance than length of life. Aspects in the management of older patients with AKI are the establishment of strategies to prevent or slow functional decline, cognitive changes and the development of additional morbidities during AKI. Assessment of fluid balance and nutritional status in older patients with AKI and appropriate replacement and monitoring are also of importance, taking into account renal function and alteration in volume distribution. The presence of AKI in the setting of critical illness should never lead to restrictions in nutritional support. Systematic cognitive testing before initiation of extracorporeal renal replacement therapy and periodically thereafter may be warranted. In addition, multidisciplinary strategies could help to reduce long-term morbidity and mortality in older patients with AKI after hospital discharge.