Dialysis Options for the Elderly Patient with Acute Kidney Injury

2015 ◽  
pp. 161-172
Author(s):  
Mitchell H. Rosner
Author(s):  
Dinna N. Cruz ◽  
Anna Clementi ◽  
Mitchell H. Rosner

Acute kidney injury (AKI) is largely a disease of the elderly patient. As described in this chapter, age-related changes in the kidney as well as the accumulated co-morbid conditions and polypharmacy associated with ageing greatly increase the susceptibility to the development of AKI. The aetiologies of AKI in the elderly patient represent the same spectrum of prerenal, intrarenal, and postrenal causes as in other age categories. However, elderly patients tend to have a higher relative risk for developing AKI due to volume depletion and urinary tract obstruction. Diagnosis of AKI can be confounded by the use of serum creatinine which has limitations in the diagnosis of AKI.Poorer short- and long-term outcomes may influence decision-making on the provision of aggressive care such as offering renal replacement therapy. These complex decisions require a careful analysis of potential outcomes as well as coordinated discussions with family members to ensure that the most thoughtful and rational treatments are offered.


2019 ◽  
Vol 72 (8) ◽  
pp. 1466-1472
Author(s):  
Grażyna Kobus ◽  
Jolanta Małyszko ◽  
Hanna Bachórzewska-Gajewska

Introduction: In the elderly, impairment of kidney function occurs. Renal diseases overlap with anatomic and functional changes related to age-related involutionary processes. Mortality among patients with acute renal injury is approximately 50%, despite advances in treatment and diagnosis of AKI. The aim: To assess the incidence of acute kidney injury in elderly patients and to analyze the causes of acute renal failure depending on age. Materials and methods: A retrospective analysis included medical documentation of patients hospitalized in the Nephrology Clinic during the 6-month period. During this period 452 patients were hospitalized in the clinic. A group of 77 patients with acute renal failure as a reason for hospitalization was included in the study. Results: The prerenal form was the most common cause of AKI in both age groups. In both age groups, the most common cause was dehydration; in the group of patients up to 65 years of age, dehydration was 29.17%; in the group of people over 65 years - 43.39%. Renal replacement therapy in patients with AKI was used in 14.29% of patients. In the group of patients up to 65 years of age hemodialysis was 16.67% and above 65 years of age. -13.21% of patients. The average creatinine level in the group of younger patients at admission was 5.16 ± 3.71 mg / dl, in the group of older patients 3.14 ± 1.63 mg / dl. The size of glomerular filtration GFR in the group of younger patients at admission was 21.14 ± 19.54 ml / min, in the group of older patients 23.34 ± 13.33 ml / min. Conclusions: The main cause of acute kidney injury regardless of the age group was dehydration. Due to the high percentage of AKI in the elderly, this group requires more preventive action, not only in the hospital but also at home.


2017 ◽  
Vol 30 (2) ◽  
pp. 131
Author(s):  
Konlawij Trongtrakul ◽  
Sujaree Poopipatpab ◽  
Ploynapas Limphunudom ◽  
Chawika Pisitsak ◽  
Kaweesak chittawatanarat ◽  
...  

2019 ◽  
pp. 123-131
Author(s):  
Myrto Giannopoulou ◽  
Stefanos Roumeliotis ◽  
Theodoros Eleftheriadis ◽  
Vassilios Liakopoulos

2013 ◽  
Vol 24 (9) ◽  
pp. 781-786
Author(s):  
Takeo Matsuyoshi ◽  
Yasusei Okada ◽  
Hiroshi Inagawa ◽  
Naoki Kojima ◽  
Kazumasa Yamaguchi ◽  
...  

2020 ◽  
Vol 10 (1) ◽  
pp. 42-50 ◽  
Author(s):  
Yuko Oyama ◽  
Yoichi Iwafuchi ◽  
Tetsuo Morioka ◽  
Ichiei Narita

Oliguric acute kidney injury (AKI) with minimal change nephrotic syndrome (MCNS) has long been recognized. Several mechanisms such as hypovolemia due to hypoalbuminemia and the nephrosarca hypothesis have been proposed. However, the precise mechanism by which MCNS causes AKI has not been fully elucidated. Herein, we describe an elderly patient with AKI caused by MCNS who fully recovered after aggressive volume withdrawal by hemodialysis and administration of a glucocorticoid. A 75-year-old woman presented with diarrhea and oliguria, and laboratory examination revealed nephrotic syndrome (NS) and severe azotemia. Fluid administration had no effect on renal dysfunction, and hemodialysis was initiated. Her renal function improved upon aggressive fluid removal through hemodialysis. Renal pathological findings revealed minimal change disease with faint mesangial deposits of IgA. After administration of methylprednisolone pulse therapy followed by oral prednisolone, she achieved complete remission from NS. The clinical course of this case supports the nephrosarca hypothesis regarding the mechanism of AKI caused by MCNS. Furthermore, appropriate fluid management and kidney biopsy are also important in elderly patients with AKI caused by NS.


2008 ◽  
Vol 52 (2) ◽  
pp. 262-271 ◽  
Author(s):  
Roland Schmitt ◽  
Steven Coca ◽  
Mehmet Kanbay ◽  
Mary E. Tinetti ◽  
Lloyd G. Cantley ◽  
...  

Renal Failure ◽  
2014 ◽  
Vol 36 (8) ◽  
pp. 1273-1277 ◽  
Author(s):  
Kadir Kayatas ◽  
Gulizar Sahin ◽  
Mehmet Tepe ◽  
Zeynep Ece Kaya ◽  
Suheyla Apaydin ◽  
...  

2017 ◽  
Vol 32 (suppl_3) ◽  
pp. iii176-iii176
Author(s):  
Fco Javier Lavilla Royo ◽  
Christian Israel Alfaro Sanchez ◽  
Omar Jose Gonzalez Aristegui ◽  
Maria José Molina Higueras ◽  
Pelayo Moiron Fernandez Hinojosa ◽  
...  

2010 ◽  
Vol 6 (3) ◽  
pp. 141-149 ◽  
Author(s):  
Alexandra Chronopoulos ◽  
Dinna N. Cruz ◽  
Claudio Ronco

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