[Risk factors for developing acute kidney injury in elderly patients]

Rev Med Inst Mex Seguro Soc. 2019 Apr 1;57(1):15-20.
[Article in Spanish]

Abstract

Background: The incidence of acute kidney injury in hospitalized elderly is a frequent event that makes them prone to complications and can even lead to death. Therefore, identifying risk factors for developing acute kidney injury becomes a priority in the process of care of the elderly.

Objective: To identify the main risk factors for acute kidney injury in hospitalized elderly and, on the basis of those risk factors, calculate the probability of presentation.

Methods: Case-control study nested in a cohort, which included patients of 60 years or older, admitted to the Internal Medicine service at an institution of social security in Querétaro, Mexico. Patients with acute kidney injury were identified as cases and patients without acute kidney injury were included in the control group. Acute kidney injury was diagnosed when there was an increased creatinine level ≥ 0.3 mg/dL (≥ 26.4 mmol/L) in a period < 48 hours.

Results: Hypovolemia and infection were identified as risk factors for acute kidney injury and they were included into the model of multiple logistic regression (y = 1,111 + 1,063 [infection] + 1.422 [hypovolemia]), (p = 0.002). The highest probability of having acute kidney injury was 80%.

Conclusions: Two factors for acute kidney injury and a prediction model were identified.

Introducción: la lesión renal aguda en pacientes ancianos hospitalizados es un evento frecuente que los predispone a complicaciones e incluso a la muerte. Es así que al atender a un anciano es prioritario identificar los factores de riesgo para presentar tal evento.

Objetivo: identificar los principales factores de riesgo para lesión renal aguda en el anciano hospitalizado y a partir de ellos, calcular la probabilidad de presentación.

Métodos: estudio de casos y controles anidado en una cohorte que incluyó pacientes de 60 años o más, ingresados en el servicio de medicina interna de una institución de seguridad social en Querétaro, México. Se identificó como caso al paciente con lesión renal aguda y como control al paciente sin lesión renal aguda. La lesión renal aguda se diagnosticó cuando existió un incremento de la creatinina ≥ 0.3 mg/dL (≥ 26.4 mmol/L) en un tiempo < 48 horas.

Resultados: se identificaron como factores de riesgo para lesión renal aguda la hipovolemia y la infección, se integraron al modelo de regresión logística múltiple (y = −1.111 + 1.063 [infección] + 1.422 [hipovolemia]) p = 0.002. La probabilidad más alta de presentar lesión renal aguda fue de 80%.

Conclusiones: se identificaron dos factores para lesión renal aguda y un modelo de predicción.

Keywords: Aged; Risk Factors; Acute Kidney Injury.

MeSH terms

  • Acute Kidney Injury / diagnosis
  • Acute Kidney Injury / etiology*
  • Age Factors
  • Aged
  • Aged, 80 and over
  • Case-Control Studies
  • Clinical Decision Rules
  • Female
  • Hospitalization
  • Humans
  • Logistic Models
  • Male
  • Middle Aged
  • Risk Factors