April - June 2019

Clinical Acute Kidney Injury (AKI) in the Elderly: A Cross Sectional Study at a Tertiary Care Hospital in Western India

Meghal Anadkat, Anand V. Thanki

1 Associate Professor, Department of General Medicine, PDU Medical College and Civil Hospital,Rajkot, Gujarat, India
2 Third Year Resident, Department of General Medicine, PDU Medical College and Civil Hospital,Rajkot, Gujarat, India


BACKGROUND AND OBJECTIVES: Acute kidney injury (AKI) is a dramatic and potentially lethal syndrome often seen by nephrologists. Elderly patients are more prone to develop acute kidney injury, due to a greater incidence of systemic illnesses.A total of 100 patients with acute kidney injury (AKI) were studied. METHODS: AKI was clinically diagnosed when serum creatinine concentration increased to more than 265 μmol/l acutely, with or without oliguria. Oliguria was defined as a urine outputof less than 500 ml/24 h. All the patients were subjected to investigations which included hematological profile, bloodurea nitrogen, serum creatinine and serum electrolyte estimation, urine examination with urinary indices and ultrasonographyof the kidneys. RESULTS: Drugs and sepsis were the predominantcauses of medical AKI in the geriatric patients. Of all the causes of geriatric AKI, which included both medical and surgical, nephrotoxic drugseither alone or in combination with other predisposingfactors were the cause in a majority of cases. Recoveryfrom AKI, as evidenced by normalization of serumcreatinine, was delayed in the elderly as compared tothe younger patients (32.0 versus 11.4 days, P<0.001).Mortality was found to be higher in the elderly as comparedto the younger patients. CONCLUSION: Nephrotoxic drugs (aminoglycoside antibiotics and non-steroidal and-inflammatory), sepsis and prostate-related causes werethe important factors for AKI in the elderly. It istherefore suggested that nephrotoxic drugs should beused with great deal of caution in elderly patients.Geriatric AKI takes a longer time to recover.

Keywords: Acute Kidney Injury, Nephrotoxic Drugs, Prostate, Sepsis

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