Kidney injury: the case of elderly patients

There is a high risk of acute kidney injury (AKI) in the elderly population. The demand for intensive care unit (ICU) admission from older patients is rising, and with it community and hospital acquired AKI are becoming more frequent. Several age-related changes render elderly patients prone to AKI development. The most frequent aetiologies for renal impairment in these patients are recent surgery, sepsis and dehydration. It is sometimes difficult to achieve an early diagnosis in the elderly ICU patient, and new biomarkers such as neutrophil gelatinase-associated lipocalin may offer a new approach. AKI treatment in this age group may be even more complex than in the general population. There are data on differences in renal recovery and mortality between the young and the old with renal injury which indicate a higher risk in fragile elderly individuals. Furthermore, it is crucial to establish all possible measures for AKI prevention in the elderly critically ill patient, since once AKI is established, mortality increases significantly.