Renal failure in the elderly

A pilot study recording the incidence, management and outcome of renal failure in elderly patients presenting to three geriatric units in a six-month period is described. A total of 4001 patients were admitted during this time and 273 patients were considered to have renal failure at presentation (criteria, plasma urea level greater than or equal to 17 mmol/l and/or creatinine level greater than or equal to 160 mumol/l). In 151 patients (55 per cent) the cause was pre-renal and this form of renal failure had a good prognosis; over 60 per cent recovered and increasing age did not affect prognosis adversely. Ninety-six patients (35 per cent) had intrinsic renal disease which was commoner in younger patients and had a mortality rate of 48 per cent. In the majority of patients renal failure was mild, only 24 per cent having a urea level greater than 31 mmol/land/or creatinine level greater than 400 mumol/l.