Skip to main content
Top
Published in: BMC Geriatrics 1/2021

Open Access 01-12-2021 | Acute Kidney Injury | Research article

Is acute kidney injury age-dependent in older adults: an observational study in two centers from North China

Authors: Libin Xu, Yanhua Wu, Yuanhan Chen, Ruiying Li, Zhiqiang Wang, Zhilian Li, Guoping Liu, Lei Yu, Wei Shi, Xinling Liang, on behalf of China collaborative study on AKI (CCS-AKI)

Published in: BMC Geriatrics | Issue 1/2021

Login to get access

Abstract

Background

Although aging increases susceptibility to acute kidney injury (AKI), whether the AKI risk and the association between AKI and adverse outcomes are age-dependent remain unclear in older adults. The current study aimed to identify whether AKI risk was age-dependent in older adults and to investigate whether the association between AKI and mortality increased with increasing age.

Methods

Medical records from 47,012 adult hospital admissions, including 30,194 older adults aged 60 or older, in two tertiary general hospitals were studied retrospectively. AKI was identified based on changes in blood creatinine levels according to the Kidney Disease: Improving Global Outcomes criteria.

Results

Among the total population and 30,194 older adult patients, the raw incidences of AKI were 8.2 and 8.3%, respectively. The curve of the age-grouped AKI incidence was “U-shaped”, which revealed a positive relationship between the AKI incidence and age among the older adults aged 75 years or older. This trend of the age-AKI relationship was supported by further multivariable analysis. After adjusting for the Charlson Comorbidity Index score, the AKI was associated with in-hospital mortality; however, the associations did not increase with increasing age.

Conclusion

The AKI risk does not increase with age in older adults, except for those aged 75 and above. The association between AKI and in-hospital death did not increase in an age-dependent manner in older adults.

Trial registration

This study was retrospectively registered at clinicaltrials.gov (NCT03054142) on February 13, 2017.
Literature
2.
go back to reference Baraldi A, Ballestri M, Rapanà R, Lucchi L, Borella P, Leonelli M, et al. Acute renal failure of medical type in an elderly population. Nephrol Dial Transplant. 1998;13:25–9.CrossRef Baraldi A, Ballestri M, Rapanà R, Lucchi L, Borella P, Leonelli M, et al. Acute renal failure of medical type in an elderly population. Nephrol Dial Transplant. 1998;13:25–9.CrossRef
3.
go back to reference Chronopoulos A, Rosner MH, Cruz DN, Ronco C. Acute kidney injury in the elderly: a review. Contrib Nephrol. 2010;165:315–21.CrossRef Chronopoulos A, Rosner MH, Cruz DN, Ronco C. Acute kidney injury in the elderly: a review. Contrib Nephrol. 2010;165:315–21.CrossRef
4.
go back to reference Bellomo R, Ronco C, Kellum JA, Mehta RL, Palevsky P, the ADQI workgroup. Acute renal failure - definition, outcome measures, animal models, fluid therapy and information technology needs: the Second International Consensus Conference of the Acute Dialysis Quality Initiative (ADQI) Group. Crit Care. 2004;8:R204–12.CrossRef Bellomo R, Ronco C, Kellum JA, Mehta RL, Palevsky P, the ADQI workgroup. Acute renal failure - definition, outcome measures, animal models, fluid therapy and information technology needs: the Second International Consensus Conference of the Acute Dialysis Quality Initiative (ADQI) Group. Crit Care. 2004;8:R204–12.CrossRef
5.
go back to reference Mehta RL, Kellum JA, Shah SV, Molitoris BA, Ronco C, Warnock DG, et al. Acute Kidney Injury Network: report of an initiative to improve outcomes in acute kidney injury. Crit Care. 2007;11:R31. Mehta RL, Kellum JA, Shah SV, Molitoris BA, Ronco C, Warnock DG, et al. Acute Kidney Injury Network: report of an initiative to improve outcomes in acute kidney injury. Crit Care. 2007;11:R31.
6.
go back to reference Lameire NH, Bagga A, Cruz D, De Maeseneer J, Endre Z, Kellum JA, et al. Acute kidney injury: an increasing global concern. Lancet. 2013;382:170. Lameire NH, Bagga A, Cruz D, De Maeseneer J, Endre Z, Kellum JA, et al. Acute kidney injury: an increasing global concern. Lancet. 2013;382:170.
7.
go back to reference Nash K, Hafeez A, Hou S. Hospital-acquired renal insufficiency. Am J Kidney Dis. 2002;39:930–6.CrossRef Nash K, Hafeez A, Hou S. Hospital-acquired renal insufficiency. Am J Kidney Dis. 2002;39:930–6.CrossRef
8.
go back to reference Pascual J, Liaño F. Causes and prognosis of acute renal failure in the very old. Madrid acute renal failure study group. J Am Geriatr Soc. 1998;46:721–5.CrossRef Pascual J, Liaño F. Causes and prognosis of acute renal failure in the very old. Madrid acute renal failure study group. J Am Geriatr Soc. 1998;46:721–5.CrossRef
9.
go back to reference Ishani A, Xue JL, Himmelfarb J, Eggers PW, Kimmel PL, Molitoris BA, et al. Acute kidney injury increases risk of ESRD among elderly. J Am Soc Nephrol. 2009;20:223–8.CrossRef Ishani A, Xue JL, Himmelfarb J, Eggers PW, Kimmel PL, Molitoris BA, et al. Acute kidney injury increases risk of ESRD among elderly. J Am Soc Nephrol. 2009;20:223–8.CrossRef
10.
go back to reference Wen J, Cheng Q, Zhao J, Ma Q, Song T, Liu S, et al. Hospital-acquired acute kidney injury in Chinese very elderly persons. J Nephrol. 2013;26:572–9.CrossRef Wen J, Cheng Q, Zhao J, Ma Q, Song T, Liu S, et al. Hospital-acquired acute kidney injury in Chinese very elderly persons. J Nephrol. 2013;26:572–9.CrossRef
11.
go back to reference Yang L, Xing G, Wang L, Wu Y, Li S, Xu G, et al. Acute kidney injury in China: a cross-sectional survey. Lancet. 2015;386:1465–71.CrossRef Yang L, Xing G, Wang L, Wu Y, Li S, Xu G, et al. Acute kidney injury in China: a cross-sectional survey. Lancet. 2015;386:1465–71.CrossRef
12.
go back to reference Van Den Noortgate N, Mouton V, Lamot C, Van Nooten G, Dhondt A, Vanholder R, et al. Outcome in a post-cardiac surgery population with acute renal failure requiring dialysis: does age make a difference. Nephrol Dial Transplant. 2003;18:732–6.CrossRef Van Den Noortgate N, Mouton V, Lamot C, Van Nooten G, Dhondt A, Vanholder R, et al. Outcome in a post-cardiac surgery population with acute renal failure requiring dialysis: does age make a difference. Nephrol Dial Transplant. 2003;18:732–6.CrossRef
13.
go back to reference Chao CT, Wu VC, Lai CF, Shiao CC, Huang TM, Wu PC, et al. Advanced age affects the outcome-predictive power of RIFLE classification in geriatric patients with acute kidney injury. Kidney Int. 2012;82:920–7.CrossRef Chao CT, Wu VC, Lai CF, Shiao CC, Huang TM, Wu PC, et al. Advanced age affects the outcome-predictive power of RIFLE classification in geriatric patients with acute kidney injury. Kidney Int. 2012;82:920–7.CrossRef
14.
go back to reference Chao CT, Lin YF, Tsai HB, Wu VC, Ko WJ. Acute kidney injury network staging in geriatric postoperative acute kidney injury patients: shortcomings and improvements. J Am Coll Surg. 2013;217:240–50.CrossRef Chao CT, Lin YF, Tsai HB, Wu VC, Ko WJ. Acute kidney injury network staging in geriatric postoperative acute kidney injury patients: shortcomings and improvements. J Am Coll Surg. 2013;217:240–50.CrossRef
15.
go back to reference Levey AS, Stevens LA, Schmid CH, Zhang YL, Castro AF 3rd, Feldman HI, et al. A new equation to estimate glomerular filtration rate. Ann Intern Med. 2009;150:604–12.CrossRef Levey AS, Stevens LA, Schmid CH, Zhang YL, Castro AF 3rd, Feldman HI, et al. A new equation to estimate glomerular filtration rate. Ann Intern Med. 2009;150:604–12.CrossRef
16.
go back to reference Kidney Disease: Improving Global Outcomes (KDIGO) Acute Kidney Injury Work Group. KDIGO Clinical Practice Guideline for Acute Kidney Injury. Kidney Int Suppl. 2012;2:1–138.CrossRef Kidney Disease: Improving Global Outcomes (KDIGO) Acute Kidney Injury Work Group. KDIGO Clinical Practice Guideline for Acute Kidney Injury. Kidney Int Suppl. 2012;2:1–138.CrossRef
17.
go back to reference Zhao Y, Yang L. Perspectives on acute kidney injury strategy in China. Nephrology (Carlton). 2018;23(Suppl 4):100–3.CrossRef Zhao Y, Yang L. Perspectives on acute kidney injury strategy in China. Nephrology (Carlton). 2018;23(Suppl 4):100–3.CrossRef
Metadata
Title
Is acute kidney injury age-dependent in older adults: an observational study in two centers from North China
Authors
Libin Xu
Yanhua Wu
Yuanhan Chen
Ruiying Li
Zhiqiang Wang
Zhilian Li
Guoping Liu
Lei Yu
Wei Shi
Xinling Liang
on behalf of China collaborative study on AKI (CCS-AKI)
Publication date
01-12-2021
Publisher
BioMed Central
Published in
BMC Geriatrics / Issue 1/2021
Electronic ISSN: 1471-2318
DOI
https://doi.org/10.1186/s12877-020-01906-z

Other articles of this Issue 1/2021

BMC Geriatrics 1/2021 Go to the issue