Characteristics of and Risk Factors for Death in Elderly Patients with Acute Kidney Injury: a Multicentre Retrospective Study in China
Overview
Authors
Affiliations
Purpose Of The Study: The 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 Design: This 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.
Results: In 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.
Conclusions: HA-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.
Acute Kidney Injury Prognosis Prediction Using Machine Learning Methods: A Systematic Review.
Lin Y, Shi T, Kong G Kidney Med. 2025; 7(1):100936.
PMID: 39758155 PMC: 11699606. DOI: 10.1016/j.xkme.2024.100936.
Lin W, Peng P, Lin S Acta Cardiol Sin. 2024; 40(4):373-382.
PMID: 39045379 PMC: 11261355. DOI: 10.6515/ACS.202407_40(4).20240411A.
Kidney biopsy in very elderly patients: indications, therapeutic impact and complications.
Fedi M, Bobot M, Torrents J, Gobert P, Magnant E, Knefati Y BMC Nephrol. 2021; 22(1):362.
PMID: 34727880 PMC: 8561868. DOI: 10.1186/s12882-021-02559-9.
Development of mortality prediction model in the elderly hospitalized AKI patients.
Peng J, Wu T, Wu X, Yan P, Kang Y, Liu Y Sci Rep. 2021; 11(1):15157.
PMID: 34312443 PMC: 8313696. DOI: 10.1038/s41598-021-94271-9.
Chandiraseharan V, Kalimuthu M, Prakash T, George T, Rajenesh A, Jayaseelan V Indian J Med Res. 2020; 152(4):386-392.
PMID: 33380703 PMC: 8061603. DOI: 10.4103/ijmr.IJMR_1685_18.