Specificity of severe AKI aetiology and care in the elderly. The IRACIBLE prospective cohort study.
AKI
AKI Aetiology
Acute Dialysis
Elderly
Journal
Journal of nephrology
ISSN: 1724-6059
Titre abrégé: J Nephrol
Pays: Italy
ID NLM: 9012268
Informations de publication
Date de publication:
11 2022
11 2022
Historique:
received:
09
11
2021
accepted:
26
03
2022
pubmed:
4
5
2022
medline:
25
10
2022
entrez:
3
5
2022
Statut:
ppublish
Résumé
Acute Kidney Injury (AKI) is increasingly common in people over 65 years of age, but its causes and management are poorly described. The purpose of this study was to describe the causes, management and prognosis of patients over 65 hospitalised for severe acute kidney injury (AKI) in all departments of a tertiary centre. The prospective IRACIBLE (IRA: AKI in French; CIBLE: target in French) cohort included 480 patients hospitalised at a university hospital over 18 months for severe AKI or subgroup of AKIN3 (Acute Kidney Injury Network classification) defined by an acute creatinine increase > 354 μmol/L or managed with acute renal replacement therapy (RRT). The history, aetiology of AKI, management, and prognosis were compared in three age groups: < 65, 65-75, and > 75 years. The study population included 480 subjects (73% men) with a median body mass index (BMI) of 26.6 kg/m Older patients hospitalised for severe AKI have a specific profile with more comorbidities, lower baseline renal function, an aetiology of AKI of mainly extra-parenchymal causes and a complex pathway of care with an overall poor prognosis.
Identifiants
pubmed: 35503200
doi: 10.1007/s40620-022-01322-z
pii: 10.1007/s40620-022-01322-z
doi:
Substances chimiques
Creatinine
AYI8EX34EU
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
2097-2108Informations de copyright
© 2022. The Author(s) under exclusive licence to Italian Society of Nephrology.
Références
Kellum JA, Lameire N, KDIGO AKI Guideline Work Group (2013) Diagnosis, evaluation, and management of acute kidney injury: a KDIGO summary (Part 1). Crit Care Lond Engl. 17(1):204
doi: 10.1186/cc11454
Silver SA, Chertow GM (2017) The economic consequences of acute kidney injury. Nephron 137(4):297–301
pubmed: 28595193
doi: 10.1159/000475607
Chertow GM, Burdick E, Honour M, Bonventre JV, Bates DW (2005) Acute kidney injury, mortality, length of stay, and costs in hospitalized patients. J Am Soc Nephrol JASN 16(11):3365–3370
pubmed: 16177006
doi: 10.1681/ASN.2004090740
Hsu RK, McCulloch CE, Dudley RA, Lo LJ, Hsu C (2013) Temporal changes in incidence of dialysis-requiring AKI. J Am Soc Nephrol JASN janv 24(1):37–42
Garnier F, Landais P, Moranne O (2019) Increased incidence of acute kidney injury requiring dialysis in metropolitan France. PLoS ONE 14(2):e0211541
pubmed: 30730975
pmcid: 6366739
doi: 10.1371/journal.pone.0211541
Kolhe NV, Muirhead AW, Wilkes SR, Fluck RJ, Taal MW (2015) National trends in acute kidney injury requiring dialysis in England between 1998 and 2013. Kidney Int 88(5):1161–1169
pubmed: 26221750
doi: 10.1038/ki.2015.234
Hsu C, McCulloch C, Fan D, Ordoñez J, Chertow G, Go A (2007) Community-based incidence of acute renal failure. Kidney Int 72(2):208–212
pubmed: 17507907
pmcid: 2673495
doi: 10.1038/sj.ki.5002297
Kolhe NV, Muirhead AW, Wilkes SR, Fluck RJ, Taal MW (2016) The epidemiology of hospitalised acute kidney injury not requiring dialysis in England from 1998 to 2013: retrospective analysis of hospital episode statistics. Int J Clin Pract 70(4):330–339
pubmed: 26799821
doi: 10.1111/ijcp.12774
Hoste EAJ, Kellum JA, Selby NM, Zarbock A, Palevsky PM, Bagshaw SM et al (2018) Global epidemiology and outcomes of acute kidney injury. Nat Rev Nephrol 14(10):607–625
pubmed: 30135570
doi: 10.1038/s41581-018-0052-0
Lameire N, Van Biesen W, Vanholder R (2005) Acute renal failure. Lancet Lond Engl. 365(9457):417–430
doi: 10.1016/S0140-6736(05)70238-5
Hoste EAJ, Bagshaw SM, Bellomo R, Cely CM, Colman R, Cruz DN et al (2015) Epidemiology of acute kidney injury in critically ill patients: the multinational AKI-EPI study. Intensive Care Med 41(8):1411–1423
pubmed: 26162677
doi: 10.1007/s00134-015-3934-7
Kellum JA, Prowle JR (2018) Paradigms of acute kidney injury in the intensive care setting. Nat Rev Nephrol 14(4):217–230
pubmed: 29355173
doi: 10.1038/nrneph.2017.184
Uchino S (2005) Acute renal failure in critically ill patients a multinational, multicenter study. JAMA 294(7):813
pubmed: 16106006
doi: 10.1001/jama.294.7.813
Chowdhury R, Peel NM, Krosch M, Hubbard RE (2017) Frailty and chronic kidney disease: A systematic review. Arch Gerontol Geriatr 68:135–142
pubmed: 27810661
doi: 10.1016/j.archger.2016.10.007
Fried LP, Tangen CM, Walston J, Newman AB, Hirsch C, Gottdiener J et al (2001) Frailty in older adults: evidence for a phenotype. J Gerontol A Biol Sci Med Sci 56(3):M146-156
pubmed: 11253156
doi: 10.1093/gerona/56.3.M146
Rockwood K, Mitnitski A (2007) Frailty in relation to the accumulation of deficits. J Gerontol Ser A 62(7):722–727
doi: 10.1093/gerona/62.7.722
Nash K, Hafeez A, Hou S (2002) Hospital-acquired renal insufficiency. Am J Kidney Dis Off J Natl Kidney Found. 39(5):930–936
doi: 10.1053/ajkd.2002.32766
O’Sullivan ED, Hughes J, Ferenbach DA (2017) Renal aging: causes and consequences. J Am Soc Nephrol JASN 28(2):407–420
pubmed: 28143966
doi: 10.1681/ASN.2015121308
Infante B, Franzin R, Madio D, Calvaruso M, Maiorano A, Sangregorio F et al (2020) Molecular mechanisms of AKI in the elderly: from animal models to therapeutic intervention. J Clin Med 9(8):2574
pmcid: 7464895
doi: 10.3390/jcm9082574
Delanaye P, Jager KJ, Bökenkamp A, Christensson A, Dubourg L, Eriksen BO et al (2019) CKD: a call for an age-adapted definition. J Am Soc Nephrol JASN 30(10):1785–1805
pubmed: 31506289
doi: 10.1681/ASN.2019030238
James MT, Grams ME, Woodward M, Elley CR, Green JA, Wheeler DC et al (2015) A Meta-analysis of the Association of Estimated GFR, Albuminuria, Diabetes Mellitus, and Hypertension With Acute Kidney Injury. Am J Kidney Dis Off J Natl Kidney Found 66(4):602–612
doi: 10.1053/j.ajkd.2015.02.338
Michel A, Martín-Pérez M, Ruigómez A, García Rodríguez LA (2016) Incidence and risk factors for severe renal impairment after first diagnosis of heart failure: a cohort and nested case-control study in UK general practice. Int J Cardiol 207:252–257
pubmed: 26808987
doi: 10.1016/j.ijcard.2016.01.167
Formica M, Politano P, Marazzi F, Tamagnone M, Serra I, Marengo M et al (2018) Acute kidney injury and chronic kidney disease in the elderly and polypharmacy. Blood Purif 46(4):332–336
pubmed: 30176676
doi: 10.1159/000492149
Pazan F, Wehling M (2021) Polypharmacy in older adults: a narrative review of definitions, epidemiology and consequences. Eur Geriatr Med 12:443–452
pubmed: 33694123
pmcid: 8149355
doi: 10.1007/s41999-021-00479-3
Fusco S, Garasto S, Corsonello A, Vena S, Mari V, Gareri P et al (2016) Medication-induced nephrotoxicity in older patients. Curr Drug Metab 17(6):608–625
pubmed: 27048182
doi: 10.2174/1389200217666160406115959
Robert L, Ficheur G, Gautier S, Servais A, Luyckx M, Soula J et al (2019) Community-acquired acute kidney injury induced by drugs in older patients: a multifactorial event. Clin Interv Aging 14:2105–2113
pubmed: 31824141
pmcid: 6901120
doi: 10.2147/CIA.S217567
Haq MFU, Yip CS, Arora P (2020) The conundrum of contrast-induced acute kidney injury. J Thorac Dis 12(4):1721–1727
pubmed: 32395314
pmcid: 7212164
doi: 10.21037/jtd.2019.12.88
Porter CJ, Moppett IK, Juurlink I, Nightingale J, Moran CG, Devonald MAJ (2017) Acute and chronic kidney disease in elderly patients with hip fracture: prevalence, risk factors and outcome with development and validation of a risk prediction model for acute kidney injury. BMC Nephrol 18(1):20
pubmed: 28088181
pmcid: 5237525
doi: 10.1186/s12882-017-0437-5
Haines RW, Fowler AJ, Kirwan CJ, Prowle JR (2019) The incidence and associations of acute kidney injury in trauma patients admitted to critical care: a systematic review and meta-analysis. J Trauma Acute Care Surg 86(1):141–147
pubmed: 30358765
doi: 10.1097/TA.0000000000002085
STARSurg Collaborative, Writing Committee, Data analysis, Steering committee, Advisory group, Regional leads et al (2018) Prognostic model to predict postoperative acute kidney injury in patients undergoing major gastrointestinal surgery based on a national prospective observational cohort study. BJS Open. 2(6):400–410
doi: 10.1002/bjs5.86
Selmi Y, Ariba YB, Labidi J (2019) Epidemiology, diagnosis, and etiology of acute kidney injury in the elderly: a retrospective analysis. Saudi J Kidney Dis Transplant Off Publ Saudi Cent Organ Transplant Saudi Arab 30(3):678–685
Brown CM, Scheven L, O’Kelly P, Dorman AM, Walshe JJ (2012) Renal histology in the elderly: indications and outcomes. J Nephrol 25(2):240–244
pubmed: 21725922
doi: 10.5301/JN.2011.8447
Pascual J, Liaño F (1998) Causes and prognosis of acute renal failure in the very old. Madrid Acute Renal Failure Study Group. J Am Geriatr Soc 46(6):721–725
pubmed: 9625188
doi: 10.1111/j.1532-5415.1998.tb03807.x
Awdishu L, Mehta RL (2017) The 6R’s of drug induced nephrotoxicity. BMC Nephrol 18(1):124
pubmed: 28372552
pmcid: 5379580
doi: 10.1186/s12882-017-0536-3
Turgutalp K, Bardak S, Horoz M, Helvacı I, Demir S, Kiykim AA (2017) Clinical outcomes of acute kidney injury developing outside the hospital in elderly. Int Urol Nephrol 49(1):113–121
pubmed: 27704319
doi: 10.1007/s11255-016-1431-8
Hu W, Lian X, Lin J, Chen Y, Wu Y, Liu W et al (2021) The incidence, characteristics, and use of suspected nephrotoxic drugs in elderly patients with community-acquired acute kidney injury. Clin Interv Aging 16:35–42
pubmed: 33442243
pmcid: 7800449
doi: 10.2147/CIA.S286660
Feest TG, Round A, Hamad S (1993) Incidence of severe acute renal failure in adults: results of a community based study. BMJ 306(6876):481–483
pubmed: 8448456
pmcid: 1676802
doi: 10.1136/bmj.306.6876.481
Ali T, Khan I, Simpson W, Prescott G, Townend J, Smith W et al (2007) Incidence and outcomes in acute kidney injury: a comprehensive population-based study. J Am Soc Nephrol JASN 18(4):1292–1298
pubmed: 17314324
doi: 10.1681/ASN.2006070756
Lámeire N, Matthys E, Vanholder R, De Keyser K, Pauwels W, Nachtergaele H et al (1987) Causes and prognosis of acute renal failure in elderly patients. Nephrol Dial Transplant Off Publ Eur Dial Transpl Assoc Eur Ren Assoc 2(5):316–322
Schmitt R, Coca S, Kanbay M, Tinetti ME, Cantley LG, Parikh CR (2008) Recovery of kidney function after acute kidney injury in the elderly: a systematic review and meta-analysis. Am J Kidney Dis Off J Natl Kidney Found. 52(2):262–271
doi: 10.1053/j.ajkd.2008.03.005
Sawhney S, Marks A, Fluck N, McLernon DJ, Prescott GJ, Black C (2017) Acute kidney injury as an independent risk factor for unplanned 90-day hospital readmissions. BMC Nephrol 18(1):9
pubmed: 28061831
pmcid: 5217258
doi: 10.1186/s12882-016-0430-4
Chawla LS, Amdur RL, Amodeo S, Kimmel PL, Palant CE (2011) The severity of acute kidney injury predicts progression to chronic kidney disease. Kidney Int 79(12):1361–1369
pubmed: 21430640
pmcid: 3257034
doi: 10.1038/ki.2011.42
Ishani A, Xue JL, Himmelfarb J, Eggers PW, Kimmel PL, Molitoris BA et al (2009) Acute kidney injury increases risk of ESRD among elderly. J Am Soc Nephrol JASN 20(1):223–228
pubmed: 19020007
doi: 10.1681/ASN.2007080837
Aglae C, Muller L, Reboul P, Cariou S, Saber Davide B, Trusson R et al (2019) Heterogeneity of cause, care, and prognosis in severe acute kidney injury in hospitalized patients: a prospective observational study. Can J Kidney Health Dis 6:2054358119892174
pubmed: 31839974
pmcid: 6896136
doi: 10.1177/2054358119892174
Bagshaw SM, Adhikari NKJ, Burns KEA, Friedrich JO, Bouchard J, Lamontagne F et al (2019) Selection and receipt of kidney replacement in critically ill older patients with AKI. Clin J Am Soc Nephrol CJASN. 14(4):496–505
pubmed: 30898872
doi: 10.2215/CJN.05530518
Druml W, Lax F, Grimm G, Schneeweiss B, Lenz K, Laggner AN (1994) Acute renal failure in the elderly 1975–1990. Clin Nephrol juin 41(6):342–349
Fønss Rasmussen L, Grode LB, Lange J, Barat I, Gregersen M (2021) Impact of transitional care interventions on hospital readmissions in older medical patients: a systematic review. BMJ Open 11(1):e040057
pubmed: 33419903
pmcid: 7799140
doi: 10.1136/bmjopen-2020-040057
Salles N, Floccia M, Videau M-N, Diallo L, Guérin D, Valentin V et al (2014) Avoiding emergency department admissions using telephonic consultations between general practitioners and hospital geriatricians. J Am Geriatr Soc 62(4):782–784
pubmed: 24731033
doi: 10.1111/jgs.12757
Conti A, Renzi N, Catarzi S, Mazzucchelli M, Covelli A, Pampana A et al (2020) Bleeding events in patients 75 years of age and older under long-term anticoagulant therapy: a real-life study. Crit Pathw Cardiol 19(3):131–138
pubmed: 32265352
doi: 10.1097/HPC.0000000000000205
Couchoud C, Stengel B, Landais P, Aldigier J-C, de Cornelissen F, Dabot C et al (2006) The renal epidemiology and information network (REIN): a new registry for end-stage renal disease in France. Nephrol Dial Transplant Off Publ Eur Dial Transpl Assoc Eur Ren Assoc. 21(2):411–418
Ronco C, Di Lullo L (2014) Cardiorenal syndrome. Heart Fail Clin 10(2):251–280
pubmed: 24656104
doi: 10.1016/j.hfc.2013.12.003
Ginès P, Guevara M, Arroyo V, Rodés J (2003) Hepatorenal syndrome. Lancet Lond Engl. 362(9398):1819–1827
doi: 10.1016/S0140-6736(03)14903-3
Singer M, Deutschman CS, Seymour CW, Shankar-Hari M, Annane D, Bauer M et al (2016) The Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3). JAMA 315(8):801–810
pubmed: 26903338
pmcid: 4968574
doi: 10.1001/jama.2016.0287
Ronco C, Bellomo R, Kellum JA (2019) Acute kidney injury. The Lancet 394(10212):1949–1964
doi: 10.1016/S0140-6736(19)32563-2
Darmon M, Ostermann M, Cerda J, Dimopoulos MA, Forni L, Hoste E et al (2017) Diagnostic work-up and specific causes of acute kidney injury. Intensive Care Med 43(6):829–840
pubmed: 28444409
doi: 10.1007/s00134-017-4799-8
Nie S, Feng Z, Tang L, Wang X, He Y, Fang J et al (2017) Risk factor analysis for aki including laboratory indicators: a nationwide multicenter study of hospitalized patients. Kidney Blood Press Res 42(5):761–773
pubmed: 29136619
doi: 10.1159/000484234
Schiffl H (2006) Renal recovery from acute tubular necrosis requiring renal replacement therapy: a prospective study in critically ill patients. Nephrol Dial Transplant Off Publ Eur Dial Transpl Assoc Eur Ren Assoc. 21(5):1248–1252
See EJ, Jayasinghe K, Glassford N, Bailey M, Johnson DW, Polkinghorne KR et al (2019) Long-term risk of adverse outcomes after acute kidney injury: a systematic review and meta-analysis of cohort studies using consensus definitions of exposure. Kidney Int 95(1):160–172
pubmed: 30473140
doi: 10.1016/j.kint.2018.08.036
Ikizler TA, Parikh CR, Himmelfarb J, Chinchilli VM, Liu KD, Coca SG et al (2021) A prospective cohort study of acute kidney injury and kidney outcomes, cardiovascular events, and death. Kidney Int 99(2):456–465
pubmed: 32707221
doi: 10.1016/j.kint.2020.06.032
Poston JT, Koyner JL (2019) Sepsis associated acute kidney injury. BMJ 364:k4891
pubmed: 30626586
pmcid: 6890472
doi: 10.1136/bmj.k4891
Van Den Noortgate N, Mouton V, Lamot C, Van Nooten G, Dhondt A, Vanholder R et al (2003) Outcome in a post-cardiac surgery population with acute renal failure requiring dialysis: does age make a difference? Nephrol Dial Transplant Off Publ Eur Dial Transpl Assoc Eur Ren Assoc. 18(4):732–736
Silveira Santos da CG, Romani RF, Benvenutti R, Ribas do Zahdi JO, Riella MC, Mazza NM (2018) Acute kidney injury in elderly population: a prospective observational study. Nephron 138(2):104–112
doi: 10.1159/000481181
Xu L, Wu Y, Chen Y, Li R, Wang Z, Li Z et al (2021) Is acute kidney injury age-dependent in older adults: an observational study in two centers from North China. BMC Geriatr 21(1):7
pubmed: 33407184
pmcid: 7789374
doi: 10.1186/s12877-020-01906-z
Hamroun A, Frimat M, Beuscart J-B, Buob D, Lionet A, Lebas C et al (2019) Spécificités des néphropathies du sujet âgé. Néphrol Thérap 15(7):533–552
doi: 10.1016/j.nephro.2019.10.001
Pinçon E, Rioux-Leclercq N, Frouget T, Le Pogamp P, Vigneau C (2010) Renal biopsies after 70 years of age: a retrospective longitudinal study from 2000 to 2007 on 150 patients in Western France. Arch Gerontol Geriatr déc 51(3):e120-124
doi: 10.1016/j.archger.2010.03.006
Di Palma AM, d’Apollo AM, Vendemia F, Stallone G, Infante B, Gesualdo L (2010) Kidney biopsy in the elderly. J Nephrol 23(Suppl 15):S55-60
pubmed: 20872372
Butler CR, O’Hare AM (2019) Complex decision making about dialysis in critically ill older adults with AKI. Clin J Am Soc Nephrol CJASN. 14(4):485–487
pubmed: 30898871
doi: 10.2215/CJN.01870219
Mesteig M, Helbostad JL, Sletvold O, Røsstad T, Saltvedt I (2010) Unwanted incidents during transition of geriatric patients from hospital to home: a prospective observational study. BMC Health Serv Res 10:1
pubmed: 20044945
pmcid: 2827472
doi: 10.1186/1472-6963-10-1
Neiterman E, Wodchis WP, Bourgeault IL (2015) Experiences of older adults in transition from hospital to community. Can J Aging Rev Can Vieil. 34(1):90–99
doi: 10.1017/S0714980814000518
Røsstad T, Garåsen H, Steinsbekk A, Håland E, Kristoffersen L, Grimsmo A (2015) Implementing a care pathway for elderly patients, a comparative qualitative process evaluation in primary care. BMC Health Serv Res 15:86
pubmed: 25888898
pmcid: 4353678
doi: 10.1186/s12913-015-0751-1
Stevens PE, Levin A, Kidney Disease: Improving Global Outcomes Chronic Kidney Disease Guideline Development Work Group Members (2013) Evaluation and management of chronic kidney disease: synopsis of the kidney disease: improving global outcomes 2012 clinical practice guideline. Ann Intern Med 158(11):825–830
pubmed: 23732715
doi: 10.7326/0003-4819-158-11-201306040-00007