Original Article
Analysis of prognosis and influencing factors in elderly acute kidney injury patients treated with renal replacement therapy
Wang Xiaolong, Cai Guangyan, Feng Zhe, Nie Sasa, Pan Sai, Lin Shupeng, Chen Xiangmei
Published 2018-12-28
Cite as Chin J Kidney Dis Invest(Electronic Edition), 2018,7(6): 264-270. DOI: 10.3877/cma.j.issn.2095-3216.2018.06.006
Abstract
ObjectiveTo understand the prognosis and its influencing factors in the elderly and young-middle-aged patients with similar severity of acute kidney injury (AKI) who also underwent renal replacement therapy (RRT) treatment.
MethodsA retrospective survey of hospitalized patients with AKI who underwent RRT from January 2013 to August 2017 in the People′s Liberation Army General Hospital. The patients were divided into the elderly group (age ≥60 years) and the young-middle-aged group (18 years≤age<60 years). The patients′ demographic data, accompanying diseases, vital signs at the initiation of RRT, laboratory tests, APACHE Ⅱ scores, SOFA scores, RRT modes, and total RRT duration, were collected to analyze the causes of AKI. The post-RRT 28-day survival rate and renal prognosis were compared between the elderly group and the young-middle-aged group. Logistic regression method was used to analyze the risk factors for mortality. Through propensity score analysis, the survival rate and renal prognosis were compared between the two groups.
ResultsThe 28-day mortality rate was 34.4% in all of the patients, 23.9% in the young-middle-aged group, and 45.5% in the elderly group, and the difference between the two groups was significant (χ2=16.27, P<0.001). After the propensity scores were matched, the mortality rate was 32.3% in the young-middle-aged group, and 38.5% in the elderly group, but the difference between the two groups was not significant (χ2=0.538, P=0.463). Regardless of whether the propensity score matching was performed to correct the overall severity of diseases between the two groups, the short-term renal prognosis in the young-middle-aged group was not significantly different from that in the elderly group. The risk factors affecting the mortality were age and tumor in the elderly patients, but was APACHE Ⅱ score in the young-middle-aged patients.
ConclusionThere was no significant difference in short-term mortality rates between the elderly and the young-middle-aged AKI patients with similar severity. In the elderly group with severe AKI, the short-term renal prognosis was not significantly different from that of the young-middle-aged group, which was still supported even after matching with the propensity scores.
Key words:
Elderly; Acute kidney injury; Renal replacement therapy; Mortality rate
Contributor Information
Wang Xiaolong
Department of Nephrology, Chinese PLA General Hospital, Chinese PLA Institute of Nephrology, State Key Laboratory of Kidney Diseases, National Clinical Research Center for Kidney Diseases, Beijing Key Laboratory of Kidney Diseases, Beijing 100853, China
Cai Guangyan
Feng Zhe
Nie Sasa
Pan Sai
Lin Shupeng
Chen Xiangmei
