Acute Kidney Injury : Gerontologic considerations

  • Gerontologic considerations
    • More susceptible to AKI
      • Dehydration
        • Polypharmacy- diuretics, laxatives
        • Illness and immobility
    • Hypotension
    • Diuretic therapy
    • Aminoglycoside therapy
    • Obstructive disorders
    • Surgery
    • Infection
  • Chronic Kidney Disease
    • Progressive, irreversible loss of kidney function
    • Mortality rates are as high as 19% to 24% for individuals with ESRD on dialysis
    • Many different causes, the leading causes are
      • Diabetes (about 50%)
      • Hypertension (about 25%).
    • Less common etiologies include glomerulonephritis, cystic diseases, and urologic diseases.
  • Stages of Chronic Kidney Disease

Description

GFR (mL/min/1.73 m2)

Clinical Action Plan

Stage 1

Kidney damage with normal or increased GFR

≥90

Diagnosis and treatment

CVD risk reduction

Slow progression

Stage 2

Kidney damage with mild decreased GFR

60-89

Estimation of progression

Stage 3a

Moderate decreased GFR

45-59

Evaluation and treatment of complications

Stage 3b

Moderate decreased GFR

30-44

More aggressive treatment of complications

Stage 4

Severe decreased GFR

15-29

Preparation for renal replacement therapy (dialysis, kidney transplant)

Stage 5

Kidney failure

<15 (or dialysis)

Renal replacement therapy (if uremia present and patient desires treatment)