[Is acute renal failure in elderly patients crucial for all-cause mortality?]

Acute kidney injury (AKI) in the elderly is associated with high risks of chronic kidney disease (CKD), hospital- and all-cause mortality. Based on the decreased renal function in older age groups and age-specific co-morbidity as hypertension, cardiovascular complications, and diabetes mellitus, the risk for AKI is increased. In outpatients inadequate pharmacotherapy and self-medication contribute to increased risk of AKI while in hospital settings severe infection, cardiovascular interventions with contrast media and major surgery may result in higher rates of AKI. Every fourth case is on risk for recurrent AKI followed by advanced CKD and renal replacement therapy. In the oldest old with high co-morbidity condition indication of renal replacement in AKI should be processed by shared-decision making. In many cases palliative care in this setting may be appropriate.