Acute+Kidney+Injury+in+Elderly+Persons.pdf

NA c a h r t D n d T a k d a p i c 7 w t M C D 1 C 0 K T 1ARRATIVE REVIEWS Acute Kidney Injury in Elderly Persons Steven G. Coca, DO, MS The incidence rate of acute kidney injury (AKI) is highest in elderly patients, who make up an ever-growing segment of the population at large. AKI in these patients is associated with an increased risk of short- and long-term death and chronic kidney disease, including end-stage renal disease. Whether AKI in older individuals carries a larger relative risk for these outcomes compared with younger individuals is unclear at this time. Other domains, such as health-related quality of life, may be mildly impacted on after an episode of AKI. No effective therapies for AKI currently are available for widespread use. However, because the incidence of AKI is highest in the elderly and the phenotype is not discernibly different from AKI in all populations, future randomized controlled trials of interventions for AKI should be performed in the elderly population. Am J Kidney Dis 56:122-131. Published by Elsevier Inc. on behalf of the National Kidney Foundation, Inc. This is a US Government Work. There are no restrictions on its use. INDEX WORDS: Acute renal failure; elderly; aged; epidemiology; outcomes; quality of life.T y o h u p l i c a o o b o 1 i t s f i r l ( a i Hcute kidney injury (AKI; formally referred to as acute renal failure) is increasingly ommon in the population at large and is associ- ted with significant morbidity, mortality, and ealth care costs. In hospitalized patients, the isk of death associated with AKI is increased 3- o 6-fold compared with those without AKI.1 espite significant advances in health care tech- ology during the past several years, the inci- ence of AKI appears to be increasing over time. his may be related to more aggressive medical nd surgical therapies that result in stress to the idney, the increasing number of comorbid con- itions in the population that accumulate during n increasing life span, and