Predictors of Mortality in Acute Kidney Injury in Elderly Patients Admitted to Geriatrics Intensive Care Unit in Egypt: A Prospective Cross-Sectional Study

Abstract

Background: Acute kidney injury (AKI) is a major problem in critically ill elderly patients in intensive care units (ICUs). It increases their morbidity, mortality, and length of ICU stay. Objective: This study aims to determine the prevalence of AKI, the factors associated with increased mortality of AKI patients, and the impact of AKI on ICU outcomes. Methods: This was a multistage cross-sectional study followed by a cohort study. Included 210 patients who were admitted to the geriatric ICU. We included the elderly aged 60 and more, and we excluded patients on regular dialysis, renal transplantation, and patients who died within the first 24 hours of admission. Results: 210 elderly patients were included in the study. The prevalence of AKI was 53.8%. Overall, in-hospital mortality was 46.2%. Mortality was higher in the AKI group compared to the non-AKI group (61.9% vs. 27.8%, p=0.001). 22.1% of patients needed renal replacement therapy. Mortality for this RRT group was 84%. In multivariable analysis, chronic kidney disease (CKD), KDIGO staging III, Acute Physiology and Chronic Health Evaluation (APACHE) II, septic shock, and diabetes (DM) were independent predictors of mortality. Conclusions: AKI is common in ICU patients. Most patients were having community-acquired AKI. Chronic kidney disease (CKD), serum creatinine at AKI diagnosis, KDIGO staging III, acute physiology and chronic health evaluation (APACHE) II, septic shock, and diabetes (DM) were independent predictors of mortality.