Incidence, causes, prognosis of renal failure in old patients admitted in an Internal Medicine Unit

Abstract

Forty-five of the 338 patients older than 70 years (13.3%), hospitalized in an internal medicine unit between October 1990 and September 1991, for a non-nephrological problem, presented with renal failure defined by a serum creatinine at or over 120 µmol/l. Renal failure was acute in 27 patients (60%), preneral in 20 patients and due to diuretics in 12 patients (45%). Two patients died during hospital stay. At discharge only 3 patients had recovered serum creatinine below 120 µmol/l. The other 40 patients with chronic renal failure, were followed-up for a mean period of two years (range 18–30 months). Renal function worsened in 4 patients. Fifteen patients died, 13 of cardiovascular problems. The mortality at 2 years in this group was compared with the mortality at 2 years of a control group of 35 patients with a serum creatinine of less than 120 µmol/l, comparable for age, sex, cardiovascular condition and autonomy, who were hospitalized during the same period in the same unit. During the 2 years of follow-up, 7 patients died (statistically not different) but only 2 of cardiovascular problems (p<0.02). Chronic renal failure often neglected or unknown is not rare in the elderly; however it may represent a predictive factor of cardiovascular mortality.