Đặc điểm của suy thận cấp ở người cao tuổi được điều trị nội khoa

Introduction and objective: Investigating some feature of elderly AKI patients treated by conservative method; Identifying prognotic factors for conservative treatment. Patients and methods: 45 AKI patients aging or = 60 years old (group 1) treated by conservative treatment, 75 AKI patients aging or = 60 years old treated hemodialysis (group 2) and 27 young AKI patients treated by conservative method (group 3) were enrolled the study from 10/2006 to 10/ 2011 in Thong Nhat Hospital, HCM City. Results: Prevalence of AKI caused by severe infection in group 1 vs group 2 was 26.67 percent vs 59.49 percent; p0.05. AKI caused by dehydration in group 1 vs group 3 was 44.44 percent vs 18.99 percent; p0.05. Percentage of AKI with oliguria and anuria in group 1 vs group 3 was 22.22 percent vs 60.71 percent (p0.05). AKI with hypotension and respiratory failure in group 1 vs group 2 was 17.78 percent vs 40.51 percent (p0.05) and 2.22 percent vs 49.37 percent (p0.05), respectively. Serum ure (mmol/L), creatinin (umol/L), potasium (mmol/L) and sodium (mmol/L) of AKI in group 1 vs group 3 were 23.67 or = 12.66 vs 20.81 or = 9.29 (p0.05), 358.56:i:200 vs 349.53 or = 283.41 (p0.05), 4.82 or = 0.99 vs 4.22 or = 1.18 (p0.05), 138.24 or = 7.47 vs 132.4l or = 7.49 (p0.05), respectively. Prognotic factors for conservative treatment in the elderly AKI patients were AKI caused by dehydration (OR: 2.71; CI 95 percent: 1.03-7.16; p0.05) and AKI without respiratory failure (34.19; CI: 4-292.23; p0.05). Conclusion: Feature of elderly AKI patients treated by conservative treatment were as following: severe infection was less common and dehydration was more common cause of AKI. Most of AKI patients were non oliguria, less severe general manifestations with low rate of hypotension and respiratory failure. Serum ure, creatinin were not different significiantly from AKI treated by conservative treatment in the young. Serum potassium was higher and hypernatremia was more severe than AKI in the young. Prognotic factors for conservative treatment in the elderly AKI were AKI caused by dehydration and AKI without respiratory failure.