Acute Renal Failure: A Study of Elderly Patients

Abstract

Two hundred and forty-six patients over the age of 65 years treated for acute renal failure (ARF) between 1960 and 1987 are reviewed. Although the fatality has apparently not changed over the duration of the study, it is possible to identify groups with a relatively good prognosis with renal replacement therapy. This particularly applies to patients with an underlying medical illness or with urological problems (excluding neoplasia). ARF following surgery with perioperative sepsis continues to carry a poor prognosis. We would recommend early referral of elderly patients with acute renal failure to a specialist unit, as a substantial proportion of survivors will regain normal renal function and quality of life.

Increased Cellular Senescence and Vascular Rarefaction Exacerbate the Progression of Kidney Fibrosis in Aged Mice Following Transient Ischemic Injury

“…Following 30 min of bilateral renal ischemia, we observed a greater mortality rate in aged mice, reminiscent of human AKI [1], [32], [33] and similar to other studies in aged rodents [4], [18], [34]. The increased mortality with age is due to a sustained loss in renal function over several days, in contrast to the young, which normalize plasma creatinine and BUN within 48 hrs of reperfusion.…”

Causes and Prognosis of Acute Renal Failure in the Very Old

“…Some authors agree that advanced age affects outcome of ARF adversely 7,8 and even suggest that age could be a criterion to determine who should receive dialytic support. We and others have demonstrated that people with ARF who are more than 65 to 70 years of age have immediate prognosis similar to that of younger patients, 5,9–14 supporting the view that age above these limits should not be used as a factor to exclude these patients from ARF treatment.…”

Acute Kidney Injury in the Elderly

“…Yet, one recent study revealed that among surviving intensive care unit patients with AKI, only approximately 55% exhibited complete recovery 187. Growing evidence also indicates that AKI is a significant risk factor for chronic kidney disease and dialysis dependence in the elderly,4, 17, 18, 54, 168, 188 with a recent meta-analysis revealing that 31% of elderly patients failed to recover renal function after an episode of AKI as compared to 26% of younger patients 17. In one recent analysis following multivariate adjustment, the risk of end-stage renal disease was 13 times higher in hospitalized elderly patients with AKI than in elderly patients without AKI 18.…”