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Review
. 2018 Aug 14:11:217-224.
doi: 10.2147/IJNRD.S170203. eCollection 2018.

Acute kidney injury in elderly patients: narrative review on incidence, risk factors, and mortality

Laís Gabriela Yokota  1 , Beatriz Mota Sampaio  1 , Erica Pires Rocha  1 , André Luís Balbi  1 , Iara Ranona Sousa Prado  1 , Daniela Ponce  1   2
Affiliations
Review

Acute kidney injury in elderly patients: narrative review on incidence, risk factors, and mortality

Laís Gabriela Yokota et al. Int J Nephrol Renovasc Dis. .

Abstract

Acute kidney injury (AKI) is characterized by a sudden renal dysfunction with consequent increase of nitrogenous products, hydroelectrolytic and acid-base disorders. Its prevalence is high in hospitalized populations (4.9%-7.2%), especially in intensive care units (ICUs). Despite all the technical and therapeutic advances that have occurred in the last few decades, the overall mortality of AKI patients remains high, reaching 80% in ICU patients. Several conditions predispose a patient to progress with AKI, including age, sepsis, surgeries, and comorbidities, such as systemic arterial hypertension, diabetes mellitus, heart disease, neoplasia, and chronic renal disease. Among these risk factors, age is emphasized, since, due to advances in the health area, there has been an increase in life expectancy, hence an increase in the demand of the elderly population for health services. At the same time, the elderly present a greater predisposition to the development of AKI, either due to kidney senility, or because of the high prevalence of comorbidities present, and medical interventions such as the use of contrasts and medications, which can also trigger AKI. Considering the relevance of the social role of the elderly and the scarcity of studies on AKI in the elderly admitted to the ICU, further studies are needed. This review article was elaborated considering the purpose: to assess incidence, risk factors, and mortality of AKI in elderly patients admitted to ICUs. Published studies were collected using the following inclusion criteria: be accessible in online databases (Lilacs, Scielo, and PubMed), have been published since 2000 and written in English, Portuguese, or Spanish. The descriptors used for the survey were "Acute Kidney Injury", "Aging", and "Elderly". All items that did not fit in the above inclusion criteria were discarded. We have also presented a synthesis of the knowledge acquired during this review.

Keywords: acute kidney injury; comorbidities; elderly; intensive care unit; mortality; risk factors.

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Conflict of interest statement

Disclosure The authors report no conflicts of interest in this work.

Figures

Figure 1
Figure 1
AKI classification according to its pathophysiology. Abbreviation: AKI, acute kidney injury.
Figure 2
Figure 2
Ischemic AKI’s pathophysiology. Abbreviations: AKI, acute kidney injury; NO, nitric oxide; PGES, prostaglandins; RAAS, renin–angiotensin–aldosterone system.
Figure 3
Figure 3
Risk factors for acute kidney injury in elderly patients. Abbreviation: AKI, acute kidney injury.
See this image and copyright information in PMC

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