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Abstract: PO0087

One-Year AKI Stage 3 Outcome in Elderly Patients at a Secondary Care Hospital in the United Kingdom

Session Information

Category: Acute Kidney Injury

  • 102 AKI: Clinical, Outcomes, and Trials

Authors

  • Rathod, Jeetendra Ramesh, Darent Valley Hospital, Dartford, Kent, United Kingdom
  • James, Matthew, Darent Valley Hospital, Dartford, Kent, United Kingdom
  • Shafqat, Syed Adnan, Darent Valley Hospital, Dartford, Kent, United Kingdom
  • Kwan, Jonathan, Darent Valley Hospital, Dartford, Kent, United Kingdom
Background

Elderly patients are prone to Acute Kidney Injury (AKI) 3 due to multiple co-morbidities and frailty. The short term and long term outcome and mortality in this group of patients is unclear.

Methods

We prospectively collected data on patients aged over 70 years with AKI 3 from the daily e-alert sent by the hospital biochemistry lab. 117 patients attended or admitted to secondary care hospital in West Kent, UK over 6.5 months between 13 December 2018 and 26 May 2019 were analysed and followed up for next 12 months. AKI 3 was defined as per KDIGO Criteria. Data was collected for age, co-morbidities, serum creatinine at admission, peak, discharge and 12 months, cause of AKI 3 and mortality. Exclusion criteria: AKI stage 1, stage 2 and patients on regular dialysis.

Results

57% patients had community acquired and 43% developed AKI 3 while as in-patient. The mean age was 80.1 + 6.2 years with co-morbidities of Chronic Kidney Disease (>3) 64.7%, Cardiovascular disease (CVD) 50%, Diabetes Mellitus 42.2% and Malignancy 8.7%. The stable baseline, peak and discharge s. creatinine (mean + std dev) were 127.7 + 85.6, 420.9 + 222.7 and 248.5 + 184.5 umol/L respectively. 59.5% patients were reviewed by nephrologists and 20.7% were transferred under renal care. 30.4% had oliguria at presentation. The reasons for AKI 3 were classified as pre-renal (59.48%), urinary obstruction (11.2%) and renal that included sepsis (13.79%), cardio-renal syndrome (3.45%), drug induced nephrotoxicity (2.6%), other renal including ATN (9.70%). Renal function recovery was complete in 44.8%, Partial in 22.4% whereas 32.8% did not have any recover. 6 (5.17%) patients needed acute haemodialysis, of these 2 died and 4 (66.6%) were discharged off dialysis and were alive at 12 months. 47.4% patients were alive at discharge with s.creatinine of 173.2 + 143.2 umol/L while only 32% of the overall patients were alive at 12 months with s. creatinine (eGFR) (mean + std dev.) 161.5 + 127 umol/L (48 + 28 ml/min) with mean follow up of 331 + 112 days. All patients that did not recover from AKI died.

Conclusion

We conclude that short and long term outcome in patients with AKI 3 aged more than 70 years has high mortality at discharge (52%) and 12 months (68%). AKI 3 is common in patients with co-morbidity of CKD, CVD and Diabetes mellitus. Outome of acute haemodialysis is effective in select group of patients.