Analysis of the reduction of glomerular filtration rate after acute renal injury in the elderly
Acute Kidney Injury, Chronic Kidney Disease, Elderly
Introduction Patients with Acute Renal Injury (AKI) have a higher risk of death and development of chronic kidney disease (CKD). It is essential to evaluate the glomerular filtration rate (GFR) in patients who had AKI, especially in the elderly population. There are still few studies that have evaluated GFR according to the severity of AKI. Objective: To analyze the effect of AKI in reducing the glomerular filtration rate in the elderly after 1 year in a tertiary hospital. Methodology: This study is a retrospective cohort conducted in a tertiary hospital. We collected data from patients with acute kidney injury aged 65 years or over who were evaluated by the nephrology service from January 1, 2012 to December 31, 2018. Only those who had at least one serum creatinine dosage after one year of aki development were included. GFR was calculated by ckd-epi formula in ml/min/1.73m2. Patients diagnosed with stage 5 chronic kidney disease (gFR estimated less than 15 ml/min/1.73m2), renal transplant recipients and those who died during hospitalization were excluded. All data were collected through the review of electronic medical records. We analyzed the mean GFR in time zero (T0) and 360 days (T1). Results: A total of 125 patients were included. We observed that the mean GFR of patients between 65 and 80 years in T0 was 60.5 ± 22.11 and in T1 of 46.6 ± 24.5 (reduction of 13.92, p<0.0001) and in patients >80 years in T0 it was 55.6 ± 22.1 and in T1 37.2 ± 20.5 (reduction of 18.3, p<0.00001). Patients with AKIN 1 had a mean reduction in GFR of 10.7 (p=0.002), AKIN 2 of 15.6 (p<0.001) and AKIN 3 of 22.3 (p< 0.00001) between T0 and T1. Patients who had GFR>60 ml/min/1.73m2 had a mean reduction in GFR of 25.02 (p<0.00001) and those with GFR< 60 ml/min/1.73m2 of 7.8 (p=0.0008). patients in >80 years and those who achieved AKIN 3. In our analysis, the reduction of GFR was more pronounced in those patients with GFR >60 ml/min/1.73m2.