Section on Infectious Diseases, Department of Internal Medicine, Wake Forest University School of Medicine, 100 Medical Center Boulevard, Winston-Salem, NC 27157-1042, USA.
J Am Soc Nephrol. 2011 Jan;22(1):28-38. doi: 10.1681/ASN.2010090934.
Aging kidneys undergo structural and functional changes that decrease autoregulatory capacity and increase susceptibility to acute injury. Acute kidney injury associates with duration and location of hospitalization, mortality risk, progression to chronic kidney disease, and functional status in daily living. Definition and diagnosis of acute kidney injury are based on changes in creatinine, which is an inadequate marker and might identify patients when it is too late. The incidence of acute kidney injury is rising and increases with advancing age, yet clinical studies have been slow to address geriatric issues or the heterogeneity in etiologies, outcomes, or patient preferences among the elderly. Here we examine some of the current literature, identify knowledge gaps, and suggest potential research questions regarding acute kidney injury in older adults. Answering these questions will facilitate the integration of geriatric issues into future mechanistic and clinical studies that affect management and care of acute kidney injury.
衰老的肾脏会发生结构和功能的变化，从而降低自身调节能力，并增加对急性损伤的易感性。急性肾损伤与住院时间和地点、死亡风险、进展为慢性肾脏病以及日常生活中的功能状态有关。急性肾损伤的定义和诊断基于肌酐的变化，而肌酐是一种不充分的标志物，可能会在为时过晚时识别出患者。急性肾损伤的发病率正在上升，并随着年龄的增长而增加，但临床研究一直缓慢地解决老年问题，或老年人的病因、结局或患者偏好的异质性问题。在这里，我们检查了一些当前的文献，确定了知识空白，并就老年人的急性肾损伤提出了一些潜在的研究问题。回答这些问题将有助于将老年问题纳入未来影响急性肾损伤管理和护理的机制和临床研究中。
