Kidney injury: the case of elderly patients

  • Alexandra Chronopoulos
  • Mitchell H. Rosner
  • Dinna N. Cruz
  • Claudio Ronco
Atti Vicenza 26–27 Maggio 2011


There is a high risk of acute kidney injury (AKI) in the elderly population. The demand for intensive care unit (ICU) admission from older patients is rising, and with it community and hospital acquired AKI are becoming more frequent. Several age-related changes render elderly patients prone to AKI development. The most frequent aetiologies for renal impairment in these patients are recent surgery, sepsis and dehydration. It is sometimes difficult to achieve an early diagnosis in the elderly ICU patient, and new biomarkers such as neutrophil gelatinase-associated lipocalin may offer a new approach. AKI treatment in this age group may be even more complex than in the general population. There are data on differences in renal recovery and mortality between the young and the old with renal injury which indicate a higher risk in fragile elderly individuals. Furthermore, it is crucial to establish all possible measures for AKI prevention in the elderly critically ill patient, since once AKI is established, mortality increases significantly.

Key words

Elderly Aging Acute kidney injury Acute renal failure Intensive care Critical illness 

Danno renale acuto nella popolazione anziana


Nella popolazione anziana il rischio di danno renale acuto (AKI) è elevato. Il numero di ricoveri di persone anziane in terapia intensiva (ICU) è in crescente aumento e di conseguenza il danno renale acuto acquisito in comunità e in ospedale sta diventando sempre più frequente. Molti cambiamenti legati all’età rendono questi soggetti maggiormente esposti allo sviluppo di insufficienza renale acuta. Talvolta è difficile porre precocemente la diagnosi nell’aziano ricoverato in ICU, e nuovi biomarcatori, come l’ENGAL, posso offrire nuove possibilità. Il trattamento dell’insufficienza renale acuta in questa classe di età può essere anche più complesso che nella popolazione generale. Dati comparativi sul recupero renale e sulla mortalità tra la popolazione giovane e nella terza età dimostrano un maggiore rischio per gli individui anziani fragili. Inoltre, é cruciale definire tutte le possibili misure di prevenzione dell’insufficienza renale acuta nei pazienti critici oltre i 60 anni, poiché una volta che l’insufficienza renale acuta si è manifestata, la mortalità aumenta in modo significativo.

Parole chiave

Anziano Invecchiamento Danno Renale Acuto Insufficienza Renale Acuta Terapia intensiva Malattia 


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Copyright information

© Springer-Verlag Italia 2011

Authors and Affiliations

  • Alexandra Chronopoulos
    • 1
  • Mitchell H. Rosner
    • 2
  • Dinna N. Cruz
    • 3
  • Claudio Ronco
    • 3
    • 4
  1. 1.Department of MedicineHôpital Hôtel-Dieu de LévisLévisCanada
  2. 2.Division of NephrologyUniversity of Virginia Health SystemCharlottesvilleUSA
  3. 3.International Renal Research Institute Vicenza (IRRIV)VicenzaItaly
  4. 4.Department of NephrologySan Bortolo HospitalVicenzaItaly

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