Acute kidney injury in the elderly population

Acute kidney injury (AKI) is associated with significant morbidity, mortality, and health care costs. In spite of significant advances in health-care technology over the past few years, the incidence of AKI appears to be increasing over time. Elderly subjects represent the segment of the general population in which the incidence of AKI has been increasing the most. AKI is usually diagnosed by an abrupt change in serum creatinine concentration. The rate and magnitude of the rise in serum creatinine may be blunted in the elderly because of the reduced muscle mass and, thus, serum creatinine is not an ideal biomarker for AKI in this population. In the last few years, several studies have suggested new biomarkers that may help the physician to better define AKI overall and in elderly patients in particular. The prevention of AKI is a crucial consideration in the management of elderly patients, since they are at high risk of developing AKI and in this particular population AKI is associated with significantly increased morbidity and mortality. Improved awareness, aiming for early detection, and implementation of preventive strategies, might lead to a decreased incidence of AKI and better outcomes in elderly patients.