In-hospital mortality in elderly patients with acute kidney injury requiring dialysis: a cohort analysis

Int Urol Nephrol. 2020 Jun;52(6):1117-1124. doi: 10.1007/s11255-020-02482-2. Epub 2020 May 5.


Objective: To determine risk factors for in-hospital mortality in elderly patients with acute kidney injury (AKI) requiring dialysis.

Introduction: AKI requiring dialysis is frequent in elderly and is associated with an increased intra-hospital mortality. With the growing number of older individuals among hospitalized patients with AKI demands a thorough investigation of the factors that contribute to their mortality to improve outcomes.

Methods: We performed a retrospective analysis of patients older than 80 years, admitted due to AKI requiring dialysis between January 2016 and December 2017. Patients who need intensive-care units (ICU) admission were excluded. The primary outcome was all-cause in-hospital mortality.

Results: A total of 154 patients were evaluated. The mean age was 85.3 ± 4.0 years and 76 patients (49.4%) were male. The overall mortality rate was 26.6%. On the multivariate analysis, serum albumin (OR 0.42 [95% CI 0.21-0.85], p 0.016), C reactive protein/albumin ratio (OR 1.04 [95% CI 0.99-1.09], and renal function recovery (OR 018 [95% CI 0.49-0.65], p 0.009) were the factors associated with higher in-hospital mortality.

Conclusions: Lower albumin level, higher C reactive protein/albumin ratio at admission, and absence of renal function recovery are associated with increased in-hospital mortality's risk in elderly with acute kidney injury requiring dialysis.

Keywords: C-reactive protein/albumin ratio; Elderly; Incident dialysis; Mortality; Renal recovery function.

MeSH terms

  • Acute Kidney Injury / mortality*
  • Acute Kidney Injury / therapy*
  • Aged
  • Aged, 80 and over
  • Cohort Studies
  • Female
  • Hospital Mortality*
  • Humans
  • Male
  • Renal Dialysis*
  • Retrospective Studies
  • Risk Factors