Clinical characteristics of elderly-onset versus non-elderly-onset acute renal infarction: A single-center comparative study / 中华老年医学杂志

ABSTRACT

Objective:To compare the clinical characteristics of elderly-onset versus non-elderly-onset acute renal infarction(ARI).Methods:Fifty-two patients with ARI diagnosed by contrast-enhanced computed tomography(CECT)or renal arteriography were classified into elderly group(onset age ≥ 65 year, n=17)and non-elderly group(onset age <65 year, n=35). Demographic data, risk factors, initial clinical presentations, laboratory data, diagnosis, treatment and prognosis were analyzed and compared between the two groups.Results:Embolic ARI was more common in elderly group than in the non-elderly group(82.4% or 14/17 vs.45.7% or 16/35, χ2=6.290, P=0.012). Patients complicated with atrial fibrillation(64.7% or 11/17 vs.34.3% or 12/35, χ2=4.290, P=0.038), coronary artery disease(52.9% or 9/17 vs.8.6% or 3/35, P=0.001)and obesity(40.0% or 4/10 vs.8.0% or 2/25, P=0.043)were more and smokers were less( P=0.007)in the elderly group than in non-elderly group.The incidence of lumbar pain( P=0.038)and the platelet count was lower( P=0.016)in elderly group than in non-elderly group.The median duration from hospital presentation to the diagnosis of ARI was shorter in elderly group than in non-elderly group[18 h(2-192) vs.48 h(2-552), Z=2.404, P=0.021]. The CECT scan was the most common diagnostic technique and anticoagulation was the most common therapy in both groups.The median time from the beginning of treatment to disappearance of symptoms were 3 d(range, 1-9)and 11 d(range, 4-50), and the median time of hospital stay were 3 d(range, 1-12)and 13 d(range, 2-64)in the elderly and non-elderly group, respectively.There was no in-hospital mortality in both groups.There was no significant difference in the prognosis between the two groups after a mean follow-up of(39.4±35.8)months( P>0.05). Conclusions:Thromboembolism due to heart disease is the main etiology of ARI in the elderly.Although elderly patients can be diagnosed relatively early, the prognosis of elderly patients is the same as that of non-elderly patients after treatment.Meanwhile, delays in diagnosis and initiating treatment for the elderly with ARI are still common.