Pronóstico de pacientes nonagenarios ingresados por fracaso renal agudo / Prognosis of in hospital nonagenarians with acute kidney injury

Fundamento: El desarrollo de un fracaso renal agudo(FRA, definido siguiendo las guías KDIGO) durante unahospitalización en pacientes nonagenarios ha sido pocoestudiado. El objetivo del presente estudio es analizar lamortalidad en pacientes nonagenarios hospitalizados quedesarrollan un FRA. Métodos: Se recogieron todos los pacientes nonagenariosque desarrollaron FRA durante el ingreso hospitalarioentre 2013 y 2014. Basalmente, se recogieron variablesepidemiológicas, comorbilidades y, durante el ingreso, variables analíticas y mortalidad. Se analizaron las variablesasociadas a mortalidad durante el episodio de FRA y lospredictores independientes mediante regresión logística. Resultados: Se incluyeron 264 pacientes nonagenarioscon FRA. La edad media fue 93±3 años, siendo 73 (27,7 %)varones. Durante la hospitalización fallecieron 79 pacientes (29,9 %). Las comorbilidades asociadas a mortalidadfueron la insuficiencia cardiaca (p = 0,018), la disfuncióndiastólica (p = 0,042) y un mayor nivel o grado de dependencia (p = 0,003). Las variables clínicas en el momentodel ingreso que se asociaron a mortalidad fueron presiónarterial sistólica y diastólica más baja (p = 0,016 y 0,013,respectivamente), leucocitosis (p = 0,003), mayor severidad del FRA valorado por AKIN (p = 0,003) y valor deácido L- láctico más alto (p = 0,005). Los predictores independientes de mortalidad fueron la insuficiencia cardiaca(OR = 2,31; IC95%: 1,07-5,00; p = 0,036), la dependencia valorada por el índice de Barthel modificado (OR = 0,80; IC95%:0,67-0,97; p < 0,016) y el L- láctico al ingreso (OR = 1,31;IC95%: 1,06-1,61; p = 0,005). Conclusión: La insuficiencia cardiaca, el nivel de dependencia y el ácido L- láctico al ingreso son predictores independientes de mortalidad en pacientes nonagenarioshospitalizados con FRA.(AU)

Background:Ñ There has been little in the way of studyof nonagenarians with acute kidney injury (AKI, definedin lines with KDIGO guidelines), but the rise in their lifeexpectancy makes further study of this population necessary. The aim of this study is to assess mortality in nonagenarians with AKI during hospitalization. Methods: In this retrospective study, patients with AKIduring hospitalization between 2013-2014 were included.At baseline, epidemiological variables, comorbidities andtreatments were collected. Analytics and mortality werestudied during hospitalisation. Univariate analysis wascarried out to evaluate mortalityssociated variables.A logistic regression analysis was carried out to demonstrate independent predictors for mortality. Results: Two hundred and sixty four nonagenarian patients were included. Mean age was 93±3 years, 73 (27.7 %)of whom were men. During hospitalization, 79 patients(29.9 %) died. Comorbidities related to mortality werehistory of heart failure (p = 0.018), diastolic dysfunction(p < 0.042) and higher dependence according to the modified Barthel index (p = 0.003). The clinical variables related to mortality at hospital admission were lower systolic(p = 0.016) and diastolic blood pressure (p = 0.013), higherwhite blood cell count (p = 0.003), greater severity of AKI(p = 0.003) and L- lactic (p = 0.005). In an adjusted multivariate analysis, history of heart failure (OR = 2.31, 95%CI:1.07-5.00, p = 0.036), dependence according to the Barthelindex (OR = 0.80, 95%CI: 0.67-0.97, p = 0.016) and L- lacticacid (OR = 1.31, 95%IC: 1.06-1.61, p = 0.005) were independent predictors of mortality. Conclusion: Heart failure, dependence according to theBarthel index and L- lactic acid at admission are independent predictors of mortality in nonagenarians hospitalizedwith AKI.

[Prognosis of in hospital nonagenarians with acute kidney injury].

BACKGROUND: There has been little in the way of study of nonagenarians with acute kidney injury (AKI, defined in lines with KDIGO guidelines), but the rise in their life expectancy makes further study of this population necessary. The aim of this study is to assess mortality in nonagenarians with AKI during hospitalization. METHODS: In this retrospective study, patients with AKI during hospitalization between 2013-2014 were included. At baseline, epidemiological variables, comorbidities and treatments were collected. Analytics and mortality were studied during hospitalisation. Univariate analysis was carried out to evaluate mortality-associated variables. A logistic regres-sion analysis was carried out to demonstrate independent predictors for mortality. RESULTS: Two hundred and sixty-four nonagenarian patients were included. Mean age was 93±3 years, 73 (27.7?%) of whom were men. During hospitalization, 79 patients (29.9?%) died. Comorbidities related to mortality were history of heart failure (p?=?0.018), diastolic dysfunction (p?