Skip to main content

Acute kidney injury in the elderly population

International Urology and Nephrology volume 42, pages 259–271 (2010)Cite this article

Abstract

The elderly population is more prone to acute kidney injury (AKI) than younger populations. Older patients have less renal reserve because of reduced glomerular filtration rates due to anatomic/functional changes, and concomitant diseases such as hypertension, diabetes, atherosclerosis, heart failure, ischemic renal disease, and obstructive uropathy. The risk of AKI may also increase as a result of aggressive diagnostic and therapeutic procedures, which include medical agents, radiology, and surgical intervention. AKI in the elderly has a multifactorial physiopathology due to different etiologies. Studies that have specifically compared prognosis of AKI in elderly versus young over the recent years suggest that age is a predictor of long-term outcome. In most cases, the treatment of AKI is similar for all age groups. The majority of critically ill patients with AKI will eventually need renal replacement therapy (RRT). The influence of RRT on renal outcome remains a subject of intense investigation and debate. Avoiding situations that could damage the kidney is an important strategy to prevent AKI development in the elderly, besides medical and interventional therapeutics.

This is a preview of subscription content, access via your institution.

Access options

Buy single article

Instant access to the full article PDF.

43,34 €

Price includes VAT (Finland)
Tax calculation will be finalised during checkout.

References

  1. Akposso K, Hertig A, Couprie R et al (2000) Acute renal failure in patients over 80 years old: 25 years experience. Intensive Care Med 26:400–406

    PubMed  Google Scholar 

  2. Fliser D, Ritz E, Franek E (1995) Renal reserve in the elderly. Semin Nephrol 15:463–467

    PubMed  Google Scholar 

  3. Musso CG, Liakopoulos V, Ioannidis I et al (2006) Acute renal failure in the elderly: particular characteristics. Int Urol Nephrol 38:787–793

    PubMed  Google Scholar 

  4. Bellomo R, Kellum J, Ronco C (2001) Acute renal failure: time for consensus. Intensive Care Med 27:1685–1688

    PubMed  Google Scholar 

  5. Kellum JA, Mehta RL, Ronco C (2001) Acute Dialysis Quality Initiative (ADQI). Contrib Nephrol 132:258–265

    PubMed  Google Scholar 

  6. Bellomo R, Ronco C, Kellum JA et al (2004) Acute renal failure—definition, outcome measures, animal models, fluid therapy and information technology needs: the Second International Consensus Conference of the Acute Dialysis Quality Initiative (ADQI) Group. Crit Care 8:R204–R210

    PubMed  Google Scholar 

  7. Kellum JA, Bellomo R, Ronco C (2008) Definition and classification of acute kidney injury. Nephron Clin Pract 109:c182–c187

    PubMed  Google Scholar 

  8. Prescott GJ, Metcalfe W, Baharani J et al (2007) A prospective national study of acute renal failure treated with RRT: incidence, aetiology and outcomes. Nephrol Dial Transplant 22:2513–2519

    PubMed  Google Scholar 

  9. Lameire N, Nelde A, Hoeben H et al (1999) Acute renal failure in the elderly. Geriatr Nephrol Urol 9:153–165

    PubMed  Google Scholar 

  10. Bellomo R (2005) Defining, quantifying, and classifying acute renal failure. Crit Care Clin 21(2):223–237

    PubMed  Google Scholar 

  11. Kaufman J, Dhakal M, Patel B et al (1991) Community-acquired acute renal failure. Am J Kidney Dis 17(2):191–198

    PubMed  Google Scholar 

  12. Feest TG, Round A, Hamad S (1993) Incidence of severe acute renal failure in adults: results of a community based study. BMJ 306:481–483

    PubMed  Google Scholar 

  13. Liano F, Pascual J (1996) Epidemiology of acute renal failure: a prospective, multicenter, community-based study. Madrid Acute Renal Failure Study Group. Kidney Int 50(3):811–818

    PubMed  Google Scholar 

  14. Nash K, Hafeez A, Hou SH (2002) Hospital-acquired renal insufficiency. Am J Kidney Dis 39(5):930–936

    PubMed  Google Scholar 

  15. Nolan CR, Anderson RJ (1998) Hospital-acquired acute renal failure. J Am Soc Nephrol 9(4):710–718

    PubMed  Google Scholar 

  16. Obialo CI, Okonofua EC, Tayade AS et al (2000) Epidemiology of de novo acute renal failure in hospitalized African Americans: comparing community-acquired vs. hospital-acquired disease. Arch Intern Med 160(9):1309–1313

    PubMed  Google Scholar 

  17. Wang Y, Cui Z, Fan M (2007) Hospital-acquired and community-acquired acute renal failure in hospitalized Chinese: a ten-year review. Ren Fail 29:163–168

    PubMed  Google Scholar 

  18. Barrantes F, Tian J, Vazquez R et al (2008) Acute kidney injury criteria predict outcomes of critically ill patients. Crit Care Med 36:1397–1403

    PubMed  Google Scholar 

  19. Kohli HS, Bhat A, Aravindan AN et al (2007) Predictors of mortality in elderly patients with acute renal failure in a developing country. Int Urol Nephrol 39(1):339–344

    PubMed  Google Scholar 

  20. Epstein M (1996) Aging and the kidney. J Am Soc Nephrol 7:1106–1122

    PubMed  Google Scholar 

  21. Van den Noortgate N, Janssens WH, Afschrift M et al (2001) Renal function in oldest-old on acute geriatric wards. Int Urol Nephrol 32:531–537

    PubMed  Google Scholar 

  22. Fliser D, Franek E, Joest M et al (1997) Renal function in elderly: impact of hypertension and cardiac function. Kidney Int 51:1196–1204

    PubMed  Google Scholar 

  23. Brown WW, Davis BB, Spry LA et al (1986) Aging and the kidney. Arch Intern Med 146:1790–1796

    PubMed  Google Scholar 

  24. Goyal VK (1982) Changes with age in the human kidney. Exp Gerontol 17:321–331

    PubMed  Google Scholar 

  25. Tracy RE, Berenson G, Wattigney W et al (1990) The evolution of benign arterionephrosclerosis from age 6 to 70 years. Am J Pathol 136:429–439

    PubMed  Google Scholar 

  26. Baert L, Steg A (1977) Is the diverticulum of the distal and collecting tubules a preliminary stage of the simple cyst in the adult? J Urol 118:707–710

    PubMed  Google Scholar 

  27. Musso CG (2002) Geriatric nephrology and the ‘nephrogeriatric giants’. Int Urol Nephrol 34:255–256

    PubMed  Google Scholar 

  28. Abrass CK, Adcox MJ, Raugi GJ (1995) Aging-associated changes in renal extracellular matrix. Am J Pathol 146:742–752

    PubMed  Google Scholar 

  29. Fuiano G, Sund S, Mazza G et al (2001) Renal hemodynamic response to maximal vasodilating stimulus in healthy older subjects. Kidney Int 59:1052–1058

    PubMed  Google Scholar 

  30. Hoang K, Tan JC, Derby G et al (2003) Determinants of glomerular hypofiltration in aging humans. Kidney Int 64:1417–1424

    PubMed  Google Scholar 

  31. Bäck SE, Ljungberg B, Nilsson-Ehle I et al (1989) Age dependence of renal function: clearance of iohexol and p-amino hippurate in healthy males. Scand J Clin Lab Invest 49:641–646

    PubMed  Google Scholar 

  32. Musso CG, Michelangelo H, Vilas M et al (2009) Creatinine reabsorption by the aged kidney. Int Urol Nephrol 41(3):727–731

    PubMed  Google Scholar 

  33. Goldberg TH, Finkelstein MS (1987) Difficulties in estimating glomerular filtration rate in the elderly. Arch Intern Med 147:1430–1433

    PubMed  Google Scholar 

  34. Wieczorowska-Tobis K, Niemir ZI, Guzik P et al (2006) Difference in estimated GFR with two different formulas in elderly individuals. Int Urol Nephrol 38:381–385

    PubMed  Google Scholar 

  35. Levey AS, Bosch JP, Lewis JB et al (1999) A more accurate method to estimate glomerular filtration rate from serum creatinine: a new prediction. Modification of diet in Renal Disease Study Group. Ann Intern Med 130:461–470

    PubMed  Google Scholar 

  36. Tian Y, Serino R, Verbalis JG et al (2004) Down regulation of renal vasopressin V2 receptor and aquaporin-2 expression parallels age-associated defects in urine concentration. Am J Physiol Renal Physiol 287:F797–F805

    PubMed  Google Scholar 

  37. Johnson TM, Miller M, Pillion DJ et al (2003) Arginine vasopressin and nocturnal polyuria in older adults with frequent nighttime voiding. J Urol 170:480–484

    PubMed  Google Scholar 

  38. Leosco D, Ferrara N, Landino P et al (1996) Effects of age on the role of atrial natriuretic factor in renal adaptation to physiologic variations of dietary salt intake. J Am Soc Nephrol 7:1045–1051

    PubMed  Google Scholar 

  39. Musso CG, Reynaldi J, Vilas M et al (2009) Fractional excretion of K, Na and Cl following furosemide infusion in healthy, young and very old people. Int Urol Nephrol (published online March 2009) [Epub ahead of print]

  40. Pascual J, Liaño F (1998) Causes and prognosis of acute renal failure in very old. Madrid Acute Renal Failure Study Group. J Am Geriatr Soc 46:721–725

    PubMed  Google Scholar 

  41. Lameire N, Van Biessen W, Vanholder R (1999) Dialysing the patient with acute renal failure in the ICU: the emperor’s clothes? Nephrol Dial Transplant 14:2570–2573

    PubMed  Google Scholar 

  42. Lopez-Gomez JM, Francisco Rivera F (2008) Renal biopsy findings in acute renal failure in the cohort of patients in the Spanish Registry of Glomerulonephritis. Clin J Am Soc Nephrol 3:674–681

    PubMed  Google Scholar 

  43. Lameire N, Matthys E, Vanholder R et al (1987) Causes and prognosis of acute renal failure in elderly patients. Nephrol Dial Transplant 2(5):316–322

    PubMed  Google Scholar 

  44. Kohli HS, Bhaskaran MC, Muthukumar T et al (2000) Treatment-related acute renal failure in the elderly: a hospital-based prospective study. Nephrol Dial Transplant 15:212–217

    PubMed  Google Scholar 

  45. Spangler PF, Risley TR, Bilyew DD (1984) The management of dehydration and incontinence in nonambulatory geriatric patients. J Appl Behav Anal 17:397–401

    PubMed  Google Scholar 

  46. Weinberg AD, Pals JK, Levesque PG et al (1994) Dehydration and death during febrile episodes in the nursing home. J Am Geriatr Soc 42:968–971

    PubMed  Google Scholar 

  47. Jerkić M, Vojvodić S, Lopez-Novoa JM (2001) The mechanism of increased renal susceptibility to toxic substances in the elderly. Part I. The role of increased vasoconstriction. Int Urol Nephrol 32:539–547

    PubMed  Google Scholar 

  48. Wen YK (2009) Impact of acute kidney injury on metformin-associated lactic acidosis. Int Urol Nephrol (published online March 2009) [Epub ahead of print]

  49. Frost L, Engholm G, Johnsen S et al (2001) Incident thromboembolism in the aorta and the renal, mesenteric, pelvic, and extremity arteries after discharge from the hospital with a diagnosis of atrial fibrillation. Arch Intern Med 161:272–276

    PubMed  Google Scholar 

  50. Haas M, Spargo BH, Wit EJ et al (2000) Etiologies and outcome of acute renal insufficiency in older adults: a renal biopsy study of 259 cases. Am J Kidney Dis 35:433–447

    PubMed  Google Scholar 

  51. Uezono S, Hara S, Sato Y, Komatsu H et al (2006) Renal biopsy in elderly patients: a clinicopathological analysis. Ren Fail 28:549–555

    PubMed  Google Scholar 

  52. Demircin G, Delibagi A, Bek K et al (2008) A one-center experience with pediatric percutaneous renal biopsy and histopathology in Ankara, Turkey. Int Urol Nephrol (published online August 2008) [Epub ahead of print]

  53. Prakash J, Singh AK, Saxena RK, Usha (2003) Glomerular diseases in the elderly in India. Int Urol Nephrol 35:283–288

    PubMed  Google Scholar 

  54. Furci L, Medici G, Baraldi A et al (1993) Rapidly progressive glomerulonephritis in the elderly. Long-term results. Contrib Nephrol 105:98–101

    PubMed  Google Scholar 

  55. Kohli HS, Bhat A, Aravindan AN, Sud K et al (2006) Spectrum of renal failure in elderly patients. Int Urol Nephrol 38(3–4):759–765

    PubMed  Google Scholar 

  56. Jeffrey RF, Gardiner DS, More IA et al (1992) Crescentic glomerulonephritis: experience of a single unit over a five year period. Scott Med J 37:175–178

    PubMed  Google Scholar 

  57. Serra A, Romero R (2002) Vasculitis with predominantly renal involvement: influence of age on the mode of presentation. Int Urol Nephrol 34(1):151–157

    PubMed  Google Scholar 

  58. Chen M, Yu F, Zhang Y et al (2008) Antineutrophil cytoplasmic autoantibody-associated vasculitis in older patients. Medicine 87:203–209

    PubMed  Google Scholar 

  59. Pascual J, Orofino L, Liaño F et al (1990) Incidence and prognosis of acute renal failure in older patients. J Am Geriatr Soc 38:25–30

    PubMed  Google Scholar 

  60. Mouzopoulos G, Lasanianos N, Mouzopoulos D (2008) Acute renal failure due to rhabdomyolysis after proximal humerus fracture associated with axillary artery rupture. Int Urol Nephrol 40(3):855–858

    PubMed  Google Scholar 

  61. Landoni G, Bove T, Crivellari M et al (2007) Acute renal failure after isolated CABG surgery: six years of experience. Minerva Anestesiol 73:559–565

    PubMed  Google Scholar 

  62. Uchino S, Kellum JA, Belloma R et al (2005) Acute renal failure in critically ill patients: a multinational, multicenter study. JAMA 294:813–818

    PubMed  Google Scholar 

  63. Garg AX, Papaioannou A, Ferko N et al (2004) Estimating the prevalence of renal in sufficiency in seniors requiring long-term care. Kidney Int 65:649–653

    PubMed  Google Scholar 

  64. Gupta BK, Spinowitz BS, Charytan C et al (1993) Cholesterol crystal embolization-associated renal failure after therapy with recombinant tissue-type plasminogen activator. Am J Kidney Dis 21:659–662

    PubMed  Google Scholar 

  65. Perazella MA (1999) Crystal-induced acute renal failure. Am J Med 106:459–465

    PubMed  Google Scholar 

  66. Schmitt R, Coca S, Kanbay M et al (2008) Recovery of kidney function after acute kidney injury in the elderly: a systematic review and meta-analysis. Am J Kidney Dis 52:262–271

    PubMed  Google Scholar 

  67. Albright RC Jr, Smelser JM, McCarthy JT et al (2000) Patient survival and renal recovery in acute renal failure: randomized comparison of cellulose acetate and polysulfone membrane dialyzers. Mayo Clin Proc 75:1141–1147

    PubMed  Google Scholar 

  68. Spurney RF, Fulkerson WJ, Schwab SJ (1991) Acute renal failure in critically ill patients: prognosis for recovery of kidney function after prolonged dialysis support. Crit Care Med 19:8–11

    PubMed  Google Scholar 

  69. Morgera S, Kraft AK, Siebert G et al (2002) Long-term outcomes in acute renal failure patients treated with continuous renal replacement therapies. Am J Kidney Dis 40:275–279

    PubMed  Google Scholar 

  70. Manns B, Doig CJ, Lee H et al (2003) Cost of acute renal failure requiring dialysis in the intensive care unit: clinical and resource implications of renal recovery. Crit Care Med 31:449–455

    PubMed  Google Scholar 

  71. Korkeila M, Ruokonen E, Takala J (2000) Costs of care, long-term prognosis and quality of life in patients requiring renal replacement therapy during intensive care. Intensive Care Med 26:1824–1831

    PubMed  Google Scholar 

  72. Schiffl H (2006) Renal recovery from acute tubular necrosis requiring renal replacement therapy: a prospective study in critically ill patients. Nephrol Dial Transplant 21:1248–1252

    PubMed  Google Scholar 

  73. Schiffl H, Fischer R (2008) Five-year outcomes of severe acute kidney injury requiring renal replacement therapy. Nephrol Dial Transplant 23:2235–2241

    PubMed  Google Scholar 

  74. Bagshaw SM, Laupland KB, Doig CJ et al (2005) Prognosis for long-term survival and renal recovery in critically ill patients with severe acute renal failure: a population-based study. Crit Care 9:700–709

    Google Scholar 

  75. Mahajan S, Tiwari S, Bhowmik D et al (2006) Factors affecting the outcome of acute renal failure among the elderly population in India: a hospital based study. Int Urol Nephrol 38:391–396

    PubMed  Google Scholar 

  76. Kohli HS, Bhat A, Aravindan AN et al (2007) Predictors of mortality in elderly patients with acute renal failure in a developing country. Int Urol Nephrol 39:339–344

    PubMed  Google Scholar 

  77. Lima RS, Marques CN, Silva Junior GB et al (2008) Comparison between early and delayed acute kidney injury secondary to infectious disease in the intensive care unit. Int Urol Nephrol 40:731–739

    PubMed  Google Scholar 

  78. Santacruz F, Barreto S, Mayor MM et al (1996) Mortality in elderly patients with acute renal failure. Ren Fail 18:601–605

    PubMed  Google Scholar 

  79. Swartz RD, Bustami RT, Daley JM et al (2005) Estimating the impact of renal replacement therapy choice on outcome in severe acute renal failure. Clin Nephrol 63:335–345

    PubMed  Google Scholar 

  80. Hoste EA, Clermont G, Kersten A et al (2006) RIFLE criteria for acute kidney injury are associated with hospital mortality in critically ill patients: a cohort analysis. Crit Care 10(3):R73

    PubMed  Google Scholar 

  81. Coca GS, Peixoto AJ, Garg AX et al (2007) The prognostic importance of a small acute decrement in kidney function in hospitalized patients: a systematic review and meta-analysis. Am J Kidney Dis 50:712–720

    PubMed  Google Scholar 

  82. Bonomini V, Stefoni S, Vangelista A (1984) Long-term patient and renal prognosis in acute renal failure. Nephron 36:169–172

    PubMed  Google Scholar 

  83. Bagshaw SM (2006) The long-term outcome after acute renal failure. Curr Opin Crit Care 12:561–566

    PubMed  Google Scholar 

  84. Van Dijk PT, Mehr DR, Ooms ME et al (2005) Comorbidity and 1-year mortality risks in nursing home residents. J Am Geriatr Soc 53:660–665

    PubMed  Google Scholar 

  85. Gijsen R, Hoeymans N, Schellevis FG et al (2001) Causes and consequences of comorbidity: a review. J Clin Epidemiol 54:661–674

    PubMed  Google Scholar 

  86. Bagshaw SM (2006) Epidemiology of renal recovery after acute renal failure. Curr Opin Crit Care 12:544–550

    PubMed  Google Scholar 

  87. Druml W (2005) Nutritional management of acute renal failure. J Ren Nutr 15:63–70

    PubMed  Google Scholar 

  88. Fiaccadori E, Parenti E, Maggiore U (2008) Nutritional support in acute kidney injury. J Nephrol 21:645–656

    PubMed  Google Scholar 

  89. Abel RM (1983) Nutritional support in the patient with acute renal failure. J Am Coll Nutr 2:33–44

    PubMed  Google Scholar 

  90. Martin CM, Doig GS, Heyland DK et al (2004) Multicentre, cluster-randomized clinical trial of algorithms for critical-care enteral and parenteral therapy (ACCEPT). CMAJ 170:197–204

    PubMed  Google Scholar 

  91. Allen DA, Harwood S, Varagunam M et al (2003) High glucose-induced oxidative stress causes apoptosis in proximal tubular epithelial cells and is mediated by multiple caspases. FASEB J 17:908–910

    PubMed  Google Scholar 

  92. Augustin R, Pocar P, Wrenzycki C et al (2003) Mitogenic and antiapoptotic activity of insulin on bovine embryos produced in vitro. Reproduction 126:91–99

    PubMed  Google Scholar 

  93. Wan L, Bellomo R, Di Giantomasso D, Ronco C (2003) The pathogenesis of septic acute renal failure. Curr Opin Crit Care 9:496–502

    PubMed  Google Scholar 

  94. Van den Berghe G, Wilmer A, Hermans G et al (2006) Intensive insulin therapy in the medical ICU. N Engl J Med 354:449–461

    PubMed  Google Scholar 

  95. Ritchie-McLean S, Kirwan C, Levy JB (2007) Is there a role for intensive insulin therapy in patients with kidney disease. Am J Kidney Dis 50:371–378

    PubMed  Google Scholar 

  96. Brezis M, Agmon Y, Epstein FH (1994) Determinants of intrarenal oxygenation. I. Effects of diuretics. Am J Physiol 267(6 Pt 2):F1059–F1062

    PubMed  Google Scholar 

  97. Besen A, Kose F, Paydas S et al (2008) The effects of the nonsteroidal anti-inflammatory drug diclofenac sodium on the rat kidney, and alteration by furosemide. Int Urol Nephrol (published online November 2008) [Epub ahead of print]

  98. Cantarovich F, Rangoonwala B, Lorenz H et al (2004) High-dose furosemide for established ARF: a prospective, randomized, double-blind, placebo controlled, multicentre trial. Am J Kidney Dis 44:402–409

    PubMed  Google Scholar 

  99. Bagshaw SM, Delaney A, Haase M et al (2007) Loop diuretics in the management of acute renal failure: a systematic review and meta-analysis. Crit Care Resusc 9:60–68

    PubMed  Google Scholar 

  100. Mehta RL, Pascual MT, Soroko S et al (2002) Diuretics, mortality, and nonrecovery of renal function in acute renal failure. JAMA 288:2547–2553

    PubMed  Google Scholar 

  101. Uchino S, Doig GS, Bellomo R et al (2004) Diuretics and mortality in acute renal failure. Crit Care Med 32:1669–1677

    PubMed  Google Scholar 

  102. Mentzer RM Jr, Oz MC, Sladen RV et al (2007) Effects of perioperative nesiritide in patients with left ventricular dysfunction undergoing cardiac surgery the NAPA trial. J Am Coll Cardiol 49:716–726

    PubMed  Google Scholar 

  103. Darveau M, Notebaert E, Denault AY et al (2002) Recombinant human erythropoietin use in intensive care. Ann Pharmacother 36:1068–1074

    PubMed  Google Scholar 

  104. Corwin HL (2004) Erythropoietin in the critically ill: is it more than just blood? Crit Care 8:325–326

    PubMed  Google Scholar 

  105. Sharples EJ, Patel N, Brown P et al (2004) Erythropoietin protects the kidney against the injury and dysfunction caused by ischemia-reperfusion. J Am Soc Nephrol 15:2115–2124

    PubMed  Google Scholar 

  106. Johnson DW, Pat B, Vesey DA et al (2006) Delayed administration of darbepoetin or erythropoietin protects against ischemic acute renal injury and failure. Kidney Int 69:1806–1813

    PubMed  Google Scholar 

  107. Humes HD, Buffington DA, Lou L et al (2003) Cell therapy with a tissue-engineered kidney reduces the multiple-organ consequences of septic shock. Crit Care Med 31:2421–2428

    PubMed  Google Scholar 

  108. Semedo P, Wang PM, Andreucci TH et al (2007) Mesenchymal stem cells ameliorate tissue damages triggered by renal ischemia and reperfusion injury. Transplant Proc 39(2):421–423

    PubMed  Google Scholar 

  109. Becherucci F, Mazzinghi B, Ronconi E (2009) The role of endothelial progenitor cells in acute kidney injury. Blood Purif 27(3):261–270

    PubMed  Google Scholar 

  110. Jo SK, Cha DR, Cho WY et al (2002) Inflammatory cytokines and lipopolysaccharide induce fas-mediated apoptosis in renal tubular cells. Nephron 91:406–415

    PubMed  Google Scholar 

  111. Turgut F, Bayrak O, Catal F et al (2008) Antioxidant and protective effects of silymarin on ischemia and reperfusion injury in the kidney tissues of rats. Int Urol Nephrol 40(2):453–460

    PubMed  Google Scholar 

  112. Splendiani G, Mazzarella V (1996) Is the choice of membrane important for patients with acute renal failure requiring hemodialysis? Artif Organs 20:281

    PubMed  Google Scholar 

  113. Ronco C, Bellomo R, Homel P et al (2000) Effects of different doses in continuous veno-venous haemofiltration on outcomes of acute renal failure: a prospective randomised trial. Lancet 356:26–30

    PubMed  Google Scholar 

  114. Schiffl H, Lang SM, Fisher R (2002) Daily hemodialysis and the outcome of acute renal failure. N Engl J Med 346:305–310

    PubMed  Google Scholar 

  115. Ash SR, Bever SL (1995) Peritoneal dialysis for acute renal failure: the safe, effective, and low-cost modality. Adv Ren Replace Ther 2:160–163

    PubMed  Google Scholar 

  116. Ismail N, Hakim RN, Oreopoulos DG et al (1993) Renal replacement therapies in elderly: Part I. Hemodialysis and chronic peritoneal dialysis. Am J Kidney Dis 22:759–782

    PubMed  Google Scholar 

  117. Manji S, Shikora S, McMahon M et al (1990) Peritoneal dialysis for acute renal failure: overfeeding resulting from dextrose absorbed during dialysis. Crit Care Med 18:29–31

    PubMed  Google Scholar 

  118. Gabriel DP, Caramori JT, Martim LC et al (2008) High volume peritoneal dialysis vs daily hemodialysis: a randomized, controlled trial in patients with acute kidney injury. Kidney Int Suppl (108):87–93

  119. Waldrop J, Ciraulo DL, Milner TP et al (2005) A comparison of continuous renal replacement therapy to intermittent dialysis in the management of renal insufficiency in the acutely ill surgical patient. Am Surg 71:36–39

    PubMed  Google Scholar 

  120. Jacka MJ, Ivancinova X, Gibney RT (2005) Continuous renal replacement therapy improves renal recovery from acute renal failure. Can J Anaesth 52:327–332

    PubMed  Google Scholar 

  121. Mehta RL, McDonald B, Gabbai FB et al (2001) A randomized clinical trial of continuous versus intermittent dialysis for acute renal failure. Kidney Int 60:1154–1163

    PubMed  Google Scholar 

  122. Uehlinger DE, Jakob SM, Ferrari P et al (2005) Comparison of continuous and intermittent renal replacement therapy for acute renal failure. Nephrol Dial Transplant 20:1630–1637

    PubMed  Google Scholar 

  123. Augustine JJ, Sandy D, Seifert TH et al (2004) A randomized controlled trial comparing intermittent with continuous dialysis in patients with ARF. Am J Kidney Dis 44:1000–1007

    PubMed  Google Scholar 

  124. Rauf AA, Long KH, Gajic O et al (2008) Intermittent hemodialysis versus continuous renal replacement therapy for acute renal failure in the intensive care unit: an observational outcomes analysis. J Intensive Care Med 23:195–203

    PubMed  Google Scholar 

  125. Lins RL, Elseviers MM, Niepen PV et al (2009) Intermittent versus continuous renal replacement therapy for acute kidney injury patients admitted to the intensive care unit: results of a randomized clinical trial. Nephrol Dial Transplant 24(2):512–518

    PubMed  Google Scholar 

  126. Uchino S, Bellomo R, Kellum JA et al (2007) Patient and kidney survival by dialysis modality in critically ill patients with acute kidney injury. Int J Artif Organs 30(4):281–292

    PubMed  Google Scholar 

  127. Pakfetrat M, Nikoo MH, Malekmakan L et al (2009) A comparison of sodium bicarbonate infusion versus normal saline infusion and its combination with oral acetazolamide for prevention of contrast-induced nephropathy: a randomized, double-blind trial. Int Urol Nephrol 41(3):629–634

    PubMed  Google Scholar 

  128. Lameire N, Verbeke M, Vanholder R (1995) Prevention of clinical acute tubular necrosis with drug therapy. Nephrol Dial Transplant 10:1992–2000

    PubMed  Google Scholar 

  129. Lameire N, Vanholder R (2000) Drug therapy of acute renal failure. IDrugs 3:1206–1216

    PubMed  Google Scholar 

Download references

Author information

Affiliations

  1. School of Medicine, Nephrology Department, Hacettepe University, 06100, Ankara, Turkey

    Rahmi Yılmaz & Yunus Erdem

Authors
  1. Rahmi Yılmaz
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Yunus Erdem
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Yunus Erdem.

Rights and permissions

Reprints and Permissions

About this article

Cite this article

Yılmaz, R., Erdem, Y. Acute kidney injury in the elderly population. Int Urol Nephrol 42, 259–271 (2010). https://doi.org/10.1007/s11255-009-9629-7

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11255-009-9629-7

Keywords

  • Acute kidney injury
  • Ageing of kidney
  • Elderly population
  • Prevention
  • Prognosis
  • Renal recovery
  • Renal replacement therapy