Department of Nephrology, San Bortolo Hospital and International Research Institute of Vicenza, 36100 Vicenza, Italy.
Nat Rev Nephrol. 2010 Mar;6(3):141-9. doi: 10.1038/nrneph.2009.234. Epub 2010 Feb 2.
Acute kidney injury (AKI) is becoming increasingly common in elderly individuals. The presence of multiple comorbidities as well as age-related changes in the kidney, systemic vasculature and immunological system render older patients more prone to renal injury. Hypovolemia, sepsis, and iatrogenic complications related to drug toxicity, contrast-induced nephropathy, and perioperative complications therefore often occur in older hospitalized patients. Although AKI is treated in the same way in elderly individuals and younger patients, elderly individuals are more vulnerable to dialysis-related complications such as hemodynamic instability, bleeding, and mild disequilibrium syndrome. Strategies for the prevention of AKI are particularly important in these fragile patients, but making an early diagnosis is especially challenging in this age group.
急性肾损伤（AKI）在老年人中越来越常见。多种合并症的存在以及肾脏、全身血管和免疫系统的年龄相关性变化，使老年患者更容易发生肾损伤。因此，老年住院患者常出现血容量不足、脓毒症和与药物毒性、造影剂肾病以及围手术期并发症相关的医源性并发症。尽管 AKI 在老年患者和年轻患者中的治疗方法相同，但老年患者更容易发生与透析相关的并发症，如血流动力学不稳定、出血和轻度失衡综合征。在这些脆弱的患者中，预防 AKI 的策略尤为重要，但在这个年龄段进行早期诊断尤其具有挑战性。
