Yokota Laís Gabriela, Sampaio Beatriz Mota, Rocha Erica Pires, Balbi André Luís, Sousa Prado Iara Ranona, Ponce Daniela
Botucatu School of Medicine, São Paulo State University (UNESP), Sao Paulo, Brazil,
Course of Medicine, University of Sao Paulo (USP), Sao Paulo, Brazil,
Int J Nephrol Renovasc Dis. 2018 Aug 14;11:217-224. doi: 10.2147/IJNRD.S170203. eCollection 2018.
Acute kidney injury (AKI) is characterized by a sudden renal dysfunction with consequent increase of nitrogenous products, hydroelectrolytic and acid-base disorders. Its prevalence is high in hospitalized populations (4.9%-7.2%), especially in intensive care units (ICUs). Despite all the technical and therapeutic advances that have occurred in the last few decades, the overall mortality of AKI patients remains high, reaching 80% in ICU patients. Several conditions predispose a patient to progress with AKI, including age, sepsis, surgeries, and comorbidities, such as systemic arterial hypertension, diabetes mellitus, heart disease, neoplasia, and chronic renal disease. Among these risk factors, age is emphasized, since, due to advances in the health area, there has been an increase in life expectancy, hence an increase in the demand of the elderly population for health services. At the same time, the elderly present a greater predisposition to the development of AKI, either due to kidney senility, or because of the high prevalence of comorbidities present, and medical interventions such as the use of contrasts and medications, which can also trigger AKI. Considering the relevance of the social role of the elderly and the scarcity of studies on AKI in the elderly admitted to the ICU, further studies are needed. This review article was elaborated considering the purpose: to assess incidence, risk factors, and mortality of AKI in elderly patients admitted to ICUs. Published studies were collected using the following inclusion criteria: be accessible in online databases (Lilacs, Scielo, and PubMed), have been published since 2000 and written in English, Portuguese, or Spanish. The descriptors used for the survey were "Acute Kidney Injury", "Aging", and "Elderly". All items that did not fit in the above inclusion criteria were discarded. We have also presented a synthesis of the knowledge acquired during this review.
急性肾损伤（AKI）的特征是肾功能突然出现障碍，导致含氮产物增加、水电解质及酸碱平衡紊乱。其在住院人群中的患病率较高（4.9%-7.2%），在重症监护病房（ICU）中尤为突出。尽管过去几十年在技术和治疗方面取得了诸多进展，但AKI患者的总体死亡率仍然很高，在ICU患者中高达80%。多种情况会使患者易患AKI，包括年龄、脓毒症、手术以及合并症，如系统性动脉高血压、糖尿病、心脏病、肿瘤和慢性肾病。在这些风险因素中，年龄因素备受关注，因为随着医疗领域的进步，预期寿命增加，老年人口对医疗服务的需求也随之上升。与此同时，老年人由于肾脏衰老，或由于合并症的高患病率，以及诸如使用造影剂和药物等医疗干预措施，也更容易发生AKI。鉴于老年人的社会角色的重要性以及针对入住ICU的老年患者AKI的研究较少，有必要开展进一步研究。这篇综述文章的撰写目的是：评估入住ICU的老年患者AKI的发病率、风险因素及死亡率。通过以下纳入标准收集已发表的研究：可在在线数据库（Lilacs、Scielo和PubMed）中获取，自2000年以来发表，且以英文、葡萄牙文或西班牙文撰写。用于检索的描述词为“急性肾损伤”、“衰老”和“老年人”。所有不符合上述纳入标准的条目均被剔除。我们还对本次综述过程中获得的知识进行了综合阐述。
