ACUTE KIDNEY INJURY IN ELDERLY PATIENTS

2019 ◽  
Vol 72 (8) ◽  
pp. 1466-1472
Author(s):  
Grażyna Kobus ◽  
Jolanta Małyszko ◽  
Hanna Bachórzewska-Gajewska
Keyword(s):  
Acute Kidney Injury ◽  
Renal Failure ◽  
Acute Renal Failure ◽  
Elderly Patients ◽  
Older Patients ◽  
Age Groups ◽  
Kidney Injury ◽  
The Elderly ◽  
Younger Patients ◽  
Common Cause

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.

Adjuvant or Palliative Chemotherapy for Colorectal Cancer in Patients 70 Years or Older

1999 ◽  
Vol 17 (8) ◽  
pp. 2412-2412 ◽  
Author(s):  
R. A. Popescu ◽  
A. Norman ◽  
P. J. Ross ◽  
B. Parikh ◽  
D. Cunningham
Keyword(s):  
Colorectal Cancer ◽  
Elderly Patients ◽  
Older Patients ◽  
Palliative Chemotherapy ◽  
Performance Status ◽  
Age Groups ◽  
Response Rates ◽  
The Elderly ◽  
Younger Patients ◽  
Royal Marsden Hospital

PURPOSE: The surgical treatment of colorectal cancer (CRC) in elderly patients (age 70 years or older) has improved, but data on adjuvant and palliative chemotherapy tolerability and benefits in this growing population remain scarce. Elderly patients are underrepresented in clinical trials, and results for older patients are seldom reported separately. PATIENTS AND METHODS: Using a prospective database, we analyzed demographics, chemotherapy toxicity, response rates, failure-free survival (FFS), and overall survival (OS) of CRC patients receiving chemotherapy at the Royal Marsden Hospital. The cutoff age was 70 years. RESULTS: A total of 844 patients received first-line chemotherapy with various fluorouracil (5-FU)-containing regimens or raltitrexed for advanced disease, and 543 patients were administered adjuvant, protracted venous infusion 5-FU or bolus 5-FU/folinic acid (FA) chemotherapy. Of the 1,387 patients, 310 were 70 years or older. There was no difference in overall or severe (Common Toxicity Criteria III to IV) toxicity between the two age groups, with the exception of more frequent severe mucositis in older patients receiving adjuvant bolus 5-FU/FA. For patients receiving palliative chemotherapy, no difference in response rates (24% v 29%, P = .19) and median FFS (164 v 168 days) were detected when the elderly were compared with younger patients. Median OS was 292 days for the elderly group and 350 days for the younger patients (P = .04), and 1-year survival was 44% and 48%, respectively. The length of inpatient hospital stay was identical. CONCLUSION: Elderly patients with good performance status tolerated adjuvant and palliative chemotherapy for CRC as well as did younger patients and had similar benefits from palliative chemotherapy.

scholarly journals Characteristics of and risk factors for death in elderly patients with acute kidney injury: a multicentre retrospective study in China

2018 ◽  
Vol 94 (1111) ◽  
pp. 249-253 ◽  
Author(s):  
Jie-Qiong Liu ◽  
Guang-Yan Cai ◽  
Shuang Liang ◽  
Wen-Ling Wang ◽  
Si-Yang Wang ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cardiovascular Disease ◽  
Mechanical Ventilation ◽  
Acute Kidney Injury ◽  
Elderly Patients ◽  
Multiple Logistic Regression Analysis ◽  
Significant Risk ◽  
Kidney Injury ◽  
The Elderly ◽  
Younger Patients

Purpose of the studyThe incidence of acute kidney injury (AKI) with a poor prognosis in the elderly has been increasing each year. This study aimed to investigate the clinical characteristics of and risk factors for death from AKI in the elderly and help improve prognosis.Study designThis study was a retrospective cohort study based on data from adult patients (≥18 years old) admitted to 15 hospitals in China between 1 January 2009 and 31 December 2011. The characteristics of AKI in the elderly were compared with those in younger patients.ResultsIn elderly patients with AKI, rates of hypertension, cardiovascular disease and multiple organ dysfunction syndrome (MODS) were higher than in younger patients (44.2% vs 31.2%, 16.1% vs 4.6% and 20.9% vs 16.9%, respectively), the length of ICU stay was longer (3.8 days vs 2.7 days, P=0.019) and renal biopsy (1.0% vs 7.13%, P<0.001) and dialysis (9.6% vs 19.2%, P<0.001) were performed less. Hospital-acquired (HA) AKI was more common than community-acquired (CA) AKI (60.3% vs 39.7%), while the most common cause of AKI was pre-renal (53.5%). Multiple logistic regression analysis showed that age (OR 1.041, 95% CI 1.023 to 1.059), cardiovascular disease (OR 1.980, 95% CI 1.402 to 2.797), cancer (OR 2.302, 95% CI 1.654 to 3.203), MODS (OR 3.023, 95% CI 1.627 to 5.620) and mechanical ventilation (OR 2.408, 95% CI 1.187 to 4.887) were significant risk factors for death.ConclusionsHA-AKI and pre-renal AKI were more common in the elderly. Age, cardiovascular disease, cancer, MODS and mechanical ventilation were independent risk factors for death in the elderly with AKI.

Renal Replacement Therapy in the Elderly

1997 ◽  
Vol 42 (5) ◽  
pp. 143-144
Author(s):  
R. S. C. Rodger ◽  
J. D. Briggs
Keyword(s):  
Cardiovascular Disease ◽  
Renal Failure ◽  
Chronic Renal Failure ◽  
Elderly Patients ◽  
Older Patients ◽  
Age Groups ◽  
The Elderly ◽  
Younger Age ◽  
Middle Aged Adults

Before 1980 few patients over the age of 65 started chronic dialysis, despite the fact that the incidence of advanced chronic renal failure was approximately ten times greater in this group compared to young and middle aged adults.1 Since that time the number of elderly patients starting renal replacement has increased markedly and accounted for 38% of new dialysis patients in Scotland in 1995. (Data supplied by the Scottish Renal Registry). In order to meet the needs of older patients with chronic renal failure there has been considerable expansion in renal services and it has been predicted that this will continue to increase in Scotland until 2010.2 The number of older patients receiving dialysis and transplantation is rising steadily and will continue to rise in the future. There is nowadays no justification for a rigid upper age limit in the selection of patients for dialysis although inevitably more elderly patients will be unsuitable on medical grounds than in the younger age groups in particular due to cardiovascular disease. The majority of elderly patients are best managed by haemodialysis but a considerable number can achieve a reasonable quality of health on peritoneal dialysis. Renal transplantation should be seriously considered in the older patient provided that comorbidity is not present, usually in the form of cardiovascular disease, to a degree which would seriously limit life expectation.

scholarly journals Pregnant Women Presented with Acute Kidney Injury: A Case Report

2015 ◽  
Vol 2 (2) ◽  
pp. 47-48
Author(s):  
Farzana Rabee Choudhury
Keyword(s):  
Acute Kidney Injury ◽  
Renal Failure ◽  
Acute Renal Failure ◽  
Multiorgan Failure ◽  
Kidney Injury ◽  
Clinical Problem ◽  
Induced Abortion ◽  
Common Cause ◽  
History Of ◽  
Septic Abortion

Acute Renal Failure is most challenging clinical problem when it occurs during pregnancy. Septic abortion is the most common cause of PRAKI in developing countries but its worldwide incidence has declined significantly. Sometimes septic abortion complicated by multiorgan failure. This 35 yrs multiparous lady having history of induced abortion, presented with multiorgan dysfunction. The patient was successfully treated and discharged with total care.Journal of Current and Advance Medical Research, 2015;2(2):47-48

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

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

Cochlear implantation in elderly patients: stability of outcome over time

2016 ◽  
Vol 130 (8) ◽  
pp. 706-711 ◽  
Author(s):  
O Hilly ◽  
E Hwang ◽  
L Smith ◽  
D Shipp ◽  
J M Nedzelski ◽  
...  
Keyword(s):  
Elderly Patients ◽  
Cochlear Implantation ◽  
Short Form ◽  
Age Groups ◽  
The Elderly ◽  
Long Term Results ◽  
Profound Hearing Loss ◽  
Younger Patients ◽  
Over Time

AbstractBackground:Cochlear implantation is the standard of care for treating severe to profound hearing loss in all age groups. There is limited data on long-term results in elderly implantees and the effect of ageing on outcomes. This study compared the stability of cochlear implantation outcome in elderly and younger patients.Methods:A retrospective chart review of cochlear implant patients with a minimum follow up of five years was conducted.Results:The study included 87 patients with a mean follow up of 6.8 years. Of these, 22 patients were older than 70 years at the time of implantation. Hearing in Noise Test scores at one year after implantation were worse in the elderly: 85.3 (aged under 61 years), 80.5 (61–70 years) and 73.6 (aged over 70 years;p= 0.039). The respective scores at the last follow up were 84.8, 85.1 and 76.5 (p= 0.054). Most patients had a stable outcome during follow up. Of the elderly patients, 13.6 per cent improved and none had a reduction in score of more than 20 per cent. Similar to younger patients, elderly patients had improved Short Form 36 Health Survey scores during follow up.Conclusion:Cochlear implantation improves both audiometric outcome and quality of life in elderly patients. These benefits are stable over time.

Acute kidney injury

2018 ◽  
Author(s):  
Aron Chakera ◽  
William G. Herrington ◽  
Christopher A. O’Callaghan
Keyword(s):  
Acute Kidney Injury ◽  
Renal Failure ◽  
Renal Function ◽  
Acute Renal Failure ◽  
Glomerular Filtration Rate ◽  
Glomerular Filtration ◽  
Filtration Rate ◽  
Urine Volume ◽  
Kidney Injury ◽  
Rapid Decrease

Acute renal failure (also referred to as acute kidney injury) refers to a rapid decrease in renal function; it is reflected by an increase in blood urea and creatinine and is often associated with oliguria (a urine volume of less than 400 ml/24 hours). It usually develops over days to weeks. Acute kidney injury has been variously classified, but the current classifications are based on the glomerular filtration rate (or creatinine), looking at changes from baseline, and the presence of oliguria or anuria. The potential etiologies of acute kidney injury are usually considered anatomically under the headings prerenal, renal (intrinsic), and postrenal. This chapter looks at the etiology, symptoms, clinical features, demographics, complications, diagnosis, and treatment of acute kidney injury.

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