Abstract: FR-PO929
Geriatric Nephrology: AKI in Elderly Patients; Differences in Etiology, Morbidity, and Mortality; Age Is Not a Prognostic Factor
Session Information
- Geriatric Nephrology
November 03, 2017 | Location: Hall H, Morial Convention Center
Abstract Time: 10:00 AM - 10:00 AM
Category: Geriatric Nephrology
- 901 Geriatric Nephrology
Authors
- Lavilla, Francisco javier, Clinica Universidad de Navarra, Pamplona, Spain
- Errasti, Pedro, Clinica Universidad de Navarra, Pamplona, Spain
- Alfaro Sanchez, Christian Israel, Clinica Universidad de Navarra, Pamplona, Spain
Background
Age is considered an acute kidney injury (AKI) prognostic factor. But can be more important than biologic age, the” clinical age” that include morbidity, acute and chronic health status. The objective is evaluate acute kidney injury (AKI) in elderly and very patient, and the influence of age as a prognostic factor.
Methods
In a cohort with 2714 hospitalizated patients (medium age 62 years, SD 0.3; 66.3 % males) with AKI (KDIGO), we made three groups (group A with age lower than 65 years, group B between 65 to 85 years and group C with more than 85 years).We evaluate AKI etiology, treatment and index prognosis (ISI –individual severity index-), chronic morbidity (cancer, chronic renal and cardiac failure, diabetes), health chronic status (Karnofsky) and acute morbidity (inflammatory status, lower hemoglobin level). We use SPSS 20.0.
Results
Exitus (%): (A: 19.5, B: 14.6, C: 14) (p=0.003)
Etiology: AKI functional (%) (A: 33.1, B: 48, C: 64) (p=0.001). ATN (%) (A: 22, B: 18.7, C: 14) (p=0.001). Complex AKI (%) (functional and ATN) (A: 39.1, B: 27.6, C 20.9) (p=0.001). Renal replacement therapy (%) (A: 28.4, B: 24.4, C: 14) (p=0.001).
Acute disease: Acute inflammatory disease (%) (A: 46.8, B: 35.6, C 29.1) (p=0.001). Surgical procedure (%) (A: 16.8, B: 25.3, C: 28.4) (p=0.001).
Chronic disease: Diabetes (%) (A: 6.7, B: 12.3, C 16.3) (p=0.001). Previous chronic kidney disease (%) (A: 34.4, B: 55.1, C: 66.3) (p=0.001). Chronic Heart disease Previous chronic kidney disease (%) (A: 2.9, B: 4.9, C: 12.8) (p=0.001). Cancer (%) (A: 62.9, B: 41, C: 14) (p=0.001).
Analytical parameters: C reactive protein peak (mg/dL) (A: 15.1 SD 0.4, B: 15.4 SD 0.42, C: 11.3 SD 1.39) (p=0.038). Lowe Hb level (g/L) (A: 8.5 SD 0.07, B: 9.2 SD 0.15, C: 9.82 SD 0.3) (p=0.001).
Acute anc chronic health status: ISI (A: 0.2818, B: 0.3272, C: 0.3651) (p=0.001). Karnofsky (A: 69.5 SD 0.4, B: 68.28 SD 0.4, C: 61.3 SD 2.02) (p=0.001)
Conclusion
The AKI in very elderly patients were more functional and less complex, with lower mortality and acute disease, but more chronic disease. Age is not the more important prognostic factor in AKI. Is more important others (some acute diseases –inflammatory- ,chronic diseases –cancer-, health chronic and acute status and AKI etiology–complexity related with previous factors-).