Acute kidney injury in the elderly population

Yılmaz, Rahmi; Erdem, Yunus

doi:10.1007/s11255-009-9629-7

Cited by 23 publications

(8 citation statements)

References 125 publications

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“…This subpopulation is more vulnerable to AKI because of the anatomical changes in the kidney with age and due to numerous factors that act as renal stressors such as dehydration, hypotension, postsurgery, nephrotoxic medications, infections, contrast medium exposure, arterial embolic event, and obstructive uropathy. [ 12 ] Thus, it is important to identify the possible etiology of AKI early by different means including kidney biopsy. AKI was the third most frequent indication for biopsy in our study accounting for 19.53% of all biopsies performed.…”

Section: Discussionmentioning

confidence: 99%

Interpretation of kidney biopsy in Indian patients older than 60 years: A tertiary care experience

et al. 2018

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The adult population above the age of 60 years has significantly increased in India, with a life expectancy of 68.4 years in 2016. Data regarding the renal histopathology in these patients are scarce though the number of native kidney biopsies done in this subset of population is increasing. The present study is a retrospective analysis of 231 biopsies from a total of 700 biopsies, from patients above 60 years of age (M = 65.8%; F = 34.2%) with a mean age of 64 ± 6.03 years. The indications for kidney biopsy included nephrotic syndrome (NS) (30.4%), nephritic syndrome (19.1%), rapidly progressive renal failure (11.7%), acute kidney injury (AKI) (15.7%), and acute worsening of preexisting chronic kidney disease (CKD) (23%). The median percentage of glomerulosclerosis was 22% (5%–45%), and interstitial fibrosis and tubular atrophy was 30% (10%–50%). The most common cause for nephrotic syndrome was membranous nephropathy (31.4%) and for nephritic syndrome was benign arterionephrosclerosis (22.7%). Postinfectious glomerulonephritis (29.6%) was the leading cause for rapidly progressive renal failure. Acute injury on CKD was notable in patients with diabetic nephropathy (30.2%). The predominant causes for AKI were acute tubulointerstitial nephritis (33.3%), acute tubular necrosis (22.2%), and acute pyelonephritis (19.4%). The biopsy proven histopathological features enabled us in tailoring the therapy. None of the patients developed life-threatening complications following ultrasonography-guided biopsy.

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Section: Discussionmentioning

confidence: 99%

Interpretation of kidney biopsy in Indian patients older than 60 years: A tertiary care experience

et al. 2018

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“…It affects between 7 and 18% of hospital inpatients (12–15) and ranges from 20–200 per million population in the community (Tables 1 and 2)(16). Hospital-acquired AKI (h-AKI) is more common in the elderly; patients presenting with community acquired AKI (c-AKI) are usually younger and healthier (17). In HI countries, while mild AKI developing in the general hospital ward has become less common, more severe forms in the intensive care unit (ICU) have become predominant.…”

Section: Why Do We Need To Raise Awareness Of the Importance Of Acutementioning

confidence: 99%

Raising awareness of acute kidney injury: a global perspective of a silent killer

Lewington

Cerdá

Mehta

2013

Kidney International

622

434

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Worldwide, acute kidney injury (AKI) is associated with poor patient outcomes. Over the last few years, collaborative efforts, enabled by a common definition of AKI, have provided a description of the epidemiology, natural history and outcomes of this disease and improved our understanding of the pathophysiology. There is increased recognition that AKI is encountered in multiple settings and in all age groups, and that its course and outcomes are influenced by the severity and duration of the event. The effect of AKI on an individual patient and the resulting societal burden that ensues from the long term effects of the disease, including development of chronic kidney disease (CKD) and end stage renal disease (ESRD), is attracting increasing scrutiny. There is evidence of marked variation in the management of AKI which is, to a large extent, due to a lack of awareness and an absence of standards for prevention, early recognition and intervention. These emerging data point to an urgent need for a global effort to highlight that AKI is preventable, its course modifiable, and its treatment can improve outcomes. In this article, we provide a framework of reference and propose specific strategies to raise awareness of AKI globally, with the goal to ultimately improve outcomes from this devastating disease.

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“…The increased numbers of medications that are required to treat systemic diseases predispose the elderly to acute tubulointerstitial diseases. Along with a decrease in functional reserve, these translate into a markedly increased incidence of acute kidney injury (AKI) in the elderly [19,20].…”

Section: Overview Of Renal Disease In the Elderlymentioning

confidence: 99%

Use of renal biopsy in the elderly

Mohamed

2010

Int Urol Nephrol

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Renal biopsy is an essential tool in the management of kidney disease. A biopsy provides a diagnosis, guides therapy and aids in prognosis, and this is true for persons of all ages. For a variety of reasons, nephrologists are sometimes hesitant to perform a biopsy in an older person. There is the major issue of a lack of perceived benefit that the biopsy will not show a treatable lesion and that therapy may not be possible in an older person. Additionally, concerns of safety may also influence the decision to biopsy. In this review, we will address these issues in the context of clinical renal syndromes and common kidney diseases in the elderly and weigh the benefit of biopsy in various situations. In general, the indications are the same as in the adult population, as is the risk associated with the biopsy procedure. Therapy, as for adults, is often successful, although further assessment of risk-benefit ratio is necessary. Age, by itself, is not a contraindication to biopsy.

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Acute kidney injury in the elderly population

Cited by 23 publications

References 125 publications

Interpretation of kidney biopsy in Indian patients older than 60 years: A tertiary care experience

Interpretation of kidney biopsy in Indian patients older than 60 years: A tertiary care experience

Raising awareness of acute kidney injury: a global perspective of a silent killer

Use of renal biopsy in the elderly

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