Hospital-acquired acute kidney injury in the elderly

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.

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Acute kidney injury in the elderly patients of Thai-surgical intensive care units (Thai-SICU) study

Australian Critical Care ◽

10.1016/j.aucc.2017.02.061 ◽

2017 ◽

Vol 30 (2) ◽

pp. 131

Author(s):

Konlawij Trongtrakul ◽

Sujaree Poopipatpab ◽

Ploynapas Limphunudom ◽

Chawika Pisitsak ◽

Kaweesak chittawatanarat ◽

...

Keyword(s):

Acute Kidney Injury ◽

Intensive Care ◽

Elderly Patients ◽

Intensive Care Units ◽

Kidney Injury ◽

The Elderly ◽

Surgical Intensive Care

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Acute Kidney Injury in the Elderly

Clinical Nephrogeriatrics ◽

10.1007/978-3-030-18711-8_8 ◽

2019 ◽

pp. 123-131

Author(s):

Myrto Giannopoulou ◽

Stefanos Roumeliotis ◽

Theodoros Eleftheriadis ◽

Vassilios Liakopoulos

Keyword(s):

Acute Kidney Injury ◽

Kidney Injury ◽

The Elderly

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The ratio of CRP to prealbumin levels predict mortality in patients with hospital-acquired acute kidney injury

BMC Nephrology ◽

10.1186/1471-2369-12-30 ◽

2011 ◽

Vol 12 (1) ◽

Cited By ~ 39

Author(s):

Qionghong Xie ◽

Ying Zhou ◽

Zhongye Xu ◽

Yanjiao Yang ◽

Dingwei Kuang ◽

...

Keyword(s):

Acute Kidney Injury ◽

Kidney Injury ◽

Hospital Acquired

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An Assessment of AKIN Criteria for Hospital-Acquired Acute Kidney Injury: A Prospective Observational Cohort Study

Nephron Clinical Practice ◽

10.1159/000317202 ◽

2010 ◽

Vol 116 (3) ◽

pp. c217-c223 ◽

Cited By ~ 9

Author(s):

Soon Hyo Kwon ◽

Hyunjin Noh ◽

Jin Seok Jeon ◽

Yongbae Kim ◽

Dong Cheol Han

Keyword(s):

Acute Kidney Injury ◽

Cohort Study ◽

Kidney Injury ◽

Observational Cohort Study ◽

Prospective Observational Cohort Study ◽

Observational Cohort ◽

Hospital Acquired

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Biomarkers of acute kidney injury: time to learn from implementation

Critical Care and Resuscitation ◽

10.51893/2021.2.pov1 ◽

2021 ◽

Vol 23 (2) ◽

pp. 137-140

Author(s):

Zoltán H Endre ◽

Keyword(s):

Acute Kidney Injury ◽

Kidney Injury ◽

Clinical Problem ◽

Time To Learn ◽

Hospital Acquired ◽

Major Clinical Problem

Acute kidney injury (AKI) is a major clinical problem in the community and in hospital, with hospital-acquired AKI reported in about 20% of adult and 30% of paediatric admissions.

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Nephrology In-Reach Services Lead to Improvement in Mortality in Acute Kidney Injury – 3 (AKI-3)

10.21203/rs.3.rs-119034/v1 ◽

2020 ◽

Author(s):

E. Gkekas ◽

TYT. Tang ◽

M. Brazell ◽

M. Brennan ◽

H. Ayub ◽

...

Keyword(s):

Acute Kidney Injury ◽

Mortality Rate ◽

District Hospital ◽

Care Pathway ◽

Kidney Injury ◽

Evaluation Study ◽

Community Settings ◽

Inclusion Criteria ◽

Hospital Acquired ◽

Overall Mortality

Abstract Background: Acute Kidney Injury (AKI) is a sudden decline in kidney function. Early detection and prompt treatment of AKI is vital in improving the outcome of patients. We introduced in-reach nephrology services at South Tyneside District Hospital (STDH) as part of a reconfiguration of local NHS services. Aims: The principal aim of this study is to analyse patient outcomes relating to service developments and to explore prognostic characteristics among a cohort of AKI-3 patients Design: This was a single centre retrospective impact evaluation study.Methods: We studied all patients (n=246) who either presented with or developed AKI-3 during their admission at South Tyneside District Hospital from 2016 to 2018. The inclusion criteria included age 18-95 years and a diagnosis of AKI-3 as per KDIGO classification. Exclusion include those on established dialysis regime or on palliative care. Results: A total of 246 patients were admitted with AKI-3. There were 64 deaths from AKI-3 over the three-year period. Mortality decreased from 29.5% to 20.7% from 2016 to 2018. In patients with Community Acquired (CA-AKI3) the overall mortality rate was 24.2% (n=182), whereas the overall mortality rate of those with Hospital Acquired (HA-AKI3) was 31.3% (n=64). The pre-AKI use of ACEi, A2RB or diuretics increased from 39.7% in 2016 (n=78), to 59.3% in 2017 (n=86) and 64.6% in 2018 (n=82). Conversely, mortality associated with the use of these medications reduced each consecutive year (32.3%, 25.5%, 18.9%).Conclusion: Development of nephrology in-reach services, staff education measures and a primary care pathway could reduce AKI-3 mortality among patients in inpatient and community settings.

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Community- and Hospital-Acquired Acute Kidney Injury

Acute Kidney Injury and Regenerative Medicine ◽

10.1007/978-981-15-1108-0_10 ◽

2020 ◽

pp. 125-144

Author(s):

Sadudee Peerapornratana ◽

Nattachai Srisawat

Keyword(s):

Acute Kidney Injury ◽

Kidney Injury ◽

Hospital Acquired

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Admission plasma uromodulin and the risk of acute kidney injury in hospitalized patients with cirrhosis: a pilot study

AJP Gastrointestinal and Liver Physiology ◽

10.1152/ajpgi.00158.2019 ◽

2019 ◽

Vol 317 (4) ◽

pp. G447-G452

Author(s):

Kavish R. Patidar ◽

Pranav S. Garimella ◽

Etienne Macedo ◽

James E. Slaven ◽

Marwan S. Ghabril ◽

...

Keyword(s):

Acute Kidney Injury ◽

Kidney Injury ◽

Predictive Biomarker ◽

Hospitalized Patients ◽

Susceptible Population ◽

Baseline Creatinine ◽

Low Levels ◽

Time Of Admission ◽

Hospital Acquired

Acute kidney injury (AKI) is a common complication in hospitalized patients with cirrhosis. Uromodulin, a protein uniquely produced by the kidney and released both in the urine and circulation, has been shown to regulate AKI and is linked to tubular reserve. Although low levels of urine uromodulin are associated with AKI after cardiac surgery, it is unclear whether circulating uromodulin can stratify the risk of AKI, particularly in a susceptible population such as hospitalized patients with cirrhosis. Thus, we investigated whether plasma uromodulin measured at the time of admission is associated with subsequent hospital-acquired AKI (defined by a rise in serum creatinine >0.3mg/dL within 48 h or ≥ 1.5 times baseline) in patients with cirrhosis. A total of 98 patients [mean age 54 yr, Model for Endstage Liver Disease Sodium (MELD-Na) score 19, and baseline creatinine of 0.95 mg/dL] were included, of which 13% ( n = 13) developed AKI. Median uromodulin levels were significantly lower in patients who developed AKI compared with patients who did not (9.30 vs. 13.35 ng/mL, P = 0.02). After adjusting for age, sex, diabetes, hypertension, albumin, and MELD-Na score as covariates on multivariable logistic regression, uromodulin was independently associated with AKI [odd ratios of 1.19 (95% confidence interval 1.02, 1.37; P = 0.02)]. Lower uromodulin levels on admission are associated with increased odds of subsequent AKI in hospitalized patients with cirrhosis. Further studies are needed to better understand the role of uromodulin in the pathogenesis and as a predictive biomarker of AKI in this population. NEW & NOTEWORTHY In this study, we found that admission plasma uromodulin levels are significantly lower in patients who developed subsequent acute kidney injury (AKI) during their hospital stay compared with patients who did not. Additionally, uromodulin is independently associated with AKI development after adjusting for clinically relevant parameters such as age, sex, diabetes, hypertension, severity of cirrhosis, and kidney function. To our knowledge, this is the first study linking plasma uromodulin with AKI development in patients with cirrhosis.

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