Clinical analysis of acute kidney injury in the hospitalized elderly patients / 中华老年医学杂志

ABSTRACT

Objective To investigate the incidence,pathogenetic factors,prognosis and correlation factors of acute kidney injury(AKI) in the hospitalized elderly patients. Methods The clinical data of 4781 elderly patients (aged 65 years and over) in our hospital from June 2008 to December 2009 were collected in this study using the hospital information system(HIS).The patients with AKI were picked out and were retrospectively analyzed. Results Among 4781patients,515cases (10.8％) suffered from AKI and the incidence of AKI increased with growing age. Single factorial analysis of etiology showed that infections (39.2％) was the most common causes of AKI.Multifactorial analysis revealed that the major causes of AKI were infections (81.0％),followed by hypovolemia (67.2 ％ ),nephrotoxic drugs (64.1％ ),cardiovascular diseases (32.3 ％),respiratory failure(17.7％) and neoplasm (9.5％). Multivariate logistic analysis and cox proportional hazard models indicated multiple organ dysfunction syndrome(MODS),gastrointestinal bleeding,mechanical ventilation and malnutrition were independent risk factors inducing end events such as dialysis or death and influencing time of live. Conclusions There is high incidence of AKI in the elderly hospitalized patient.Infections,hypovolemia,nephrotoxic drugs and cardiovascular diseases are the common causes of AKI.Active treatment of primary diseases,early diagnosis and prevention are beneficial for improving the prognosis of AKI.