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Outcomes of hospital-acquired acute kidney injury in elderly patients: a single-centre study

  • Nephrology - Original Paper
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Abstract

Background

HAAKI is a common clinical problem in hospitalized patients. Its incidence is high in older patients and carries worse prognosis. The presence of multiple co-morbidities, aging process, and frequent diagnostic and therapeutic interventions predispose elderly patients to HAAKI. This study aims to evaluate the spectrum, risk factors and determinants of outcome of elderly patients with HAAKI.

Methods

This prospective study was conducted during January 2014 to September 2015 in the Department of nephrology, Institute of Medical Sciences, BHU, Varanasi, UP, India. First 100 HAAKI elderly (> 60 years) patients, who fulfilled the inclusion criteria were enrolled for study. HAAKI was defined as per RIFLE criteria after minimum 48 h of hospitalization. Clinical, biochemical, and radiological evaluation were done. Follow up was done till discharge or up to 30 days whichever was later.

Results

Till selection and enrollment of first 100 HAAKI patients, total 23507 patients were hospitalized. 11.2% (n = 2635) patients were ≥ 60 years of age. Among 2635 elderly patients, 3.79% (n = 100) developed HAAKI. Commonest causes of HAAKI were sepsis (37%) followed by drugs like NSAID, Contrast agent, Amphotericin B, and antibiotics including amino glycosides in (24%) patents. DM and HTN were the commonest risk factors. Mortality was noted in 45% cases and rest 55% patients recovered with partial or full recovery of renal function. ICU admission, Oliguria, RIFLE-F, need of RRT, and SOFA score > 11 were independent determinants of outcome of elderly patients with HAAKI.

Conclusion

HAAKI is associated with increased morbidity and mortality in elderly patients. Associated co-morbid conditions predispose elderly patients to HAAKI. ICU admission, Oliguria, severity of renal failure, requirement of RRT, and initial SOFA score were strong predictors of survival of elderly patients with HAAKI.

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Acknowledgements

Authors having no conflict of interests. No funds were provided by any agencies for this study. I would like to thank Dr Alok Kumar for their help in data analysis.

Funding

This study was observational study and not funded by any organization or agency.

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Authors and Affiliations

  1. Department of Nephrology, IMS, BHU, Vanarasi, UP, India

    Shivendra Singh, Prem Shankar Patel, Prodip Kumar Doley, Shiv Shankar Sharma, Mohd. Iqbal & Anupam Agarwal

  2. Centre for Clinical Investigation, SSH, BHU, Varanasi, India

    Neelam Singh

  3. Division of Statistics, Department of PSM, IMS, BHU, Varanasi, UP, India

    Alok Kumar

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  1. Shivendra Singh
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  2. Prem Shankar Patel
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Correspondence to Prem Shankar Patel.

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Ethical approval

This study was observation study involving human subjects and participants didn’t undergo any invasive procedure. This study was approved by Ethical Committee of Institute of Medical sciences, Banaras Hindu University, Varanasi, UP and India.

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Informed consent was obtained from all individual participants involved in this study.

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Singh, S., Patel, P.S., Doley, P.K. et al. Outcomes of hospital-acquired acute kidney injury in elderly patients: a single-centre study. Int Urol Nephrol 51, 875–883 (2019). https://doi.org/10.1007/s11255-019-02130-4

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