Earlier nephrology consultation may not be associated with improved short-term survival of acute kidney injury in very elderly men

Qinglin Li,1 Meng Zhao,2 Jing Du,1 Xiaodan Wang1 1Department of Geriatric Nephrology, 2Department of Clinical Data Repository, Chinese People’s Liberation Army General Hospital, Beijing, China Objectives: A delayed nephrology consultation (NC) may be associated with a poor prognosis in a...

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Autores principales:	Li Q, Zhao M, Du J, Wang X
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2016
Materias:	Acute kidney injury Very elderly Mortality Nephrology consultation Geriatrics RC952-954.6
Acceso en línea:	https://doaj.org/article/7ba8770610de43bc84ec455eb6044542
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spelling	oai:doaj.org-article:7ba8770610de43bc84ec455eb60445422021-12-02T02:47:30ZEarlier nephrology consultation may not be associated with improved short-term survival of acute kidney injury in very elderly men1178-1998https://doaj.org/article/7ba8770610de43bc84ec455eb60445422016-12-01T00:00:00Zhttps://www.dovepress.com/earlier-nephrology-consultation-may-not-be-associated--with-improved-s-peer-reviewed-article-CIAhttps://doaj.org/toc/1178-1998Qinglin Li,1 Meng Zhao,2 Jing Du,1 Xiaodan Wang1 1Department of Geriatric Nephrology, 2Department of Clinical Data Repository, Chinese People’s Liberation Army General Hospital, Beijing, China Objectives: A delayed nephrology consultation (NC) may be associated with a poor prognosis in acute kidney injury (AKI) patients. The aims of this study were to compare the clinical and laboratory characteristics of elderly AKI patients evaluated and not evaluated by nephrologists and to generate a hypothesis regarding the relationship between the timing of the NC and 90-day outcomes. Methods: From 2007 to 2015, this study explored associations among the presence and timing of NC with the non-intensive care unit stay and 90-day mortality in elderly AKI patients at the Geriatric Department of the Chinese People’s Liberation Army General Hospital. Early NC and delayed NC were defined as NCs performed before and 2 days after the day of AKI diagnosis, respectively. Multivariable logistic regression was used to adjust for confounding and selection bias. Results: In total, 623 patients were included for the final analysis, of whom 162 (26%) were evaluated by nephrologists. The 90-day mortality rate was 33.2%, and dialysis was required in 1.4% of patients (9/623). Multivariable analysis showed that a higher prevalence of preexisting chronic obstructive pulmonary disease, AKI diagnosis time, peak serum creatinine level, blood urea nitrogen level, AKI stage, and mortality was associated with the NC. The NC was delayed (>48 h) in 59 patients (36.4%) (median time to consultation, 4 days). The median AKI diagnosis time, presence of oliguria, uric acid level, and a more severe AKI stage were associated with delayed consultation. Moreover, delayed consultation presented a similar 90-day mortality rate to that of an early NC (50.8% vs 44.7%, respectively, P=0.448). Conclusion: In very elderly AKI patients, those evaluated by nephrologists have more severe AKI and a higher mortality rate than those not evaluated by nephrologists. An earlier NC may not be associated with improved 90-day survival. Keywords: acute kidney injury, very elderly, mortality, nephrology consultation, risk factors, outcomesLi QZhao MDu JWang XDove Medical PressarticleAcute kidney injuryVery elderlyMortalityNephrology consultationGeriatricsRC952-954.6ENClinical Interventions in Aging, Vol Volume 12, Pp 11-18 (2016)
institution	DOAJ
collection	DOAJ
language	EN
topic	Acute kidney injury Very elderly Mortality Nephrology consultation Geriatrics RC952-954.6
spellingShingle	Acute kidney injury Very elderly Mortality Nephrology consultation Geriatrics RC952-954.6 Li Q Zhao M Du J Wang X Earlier nephrology consultation may not be associated with improved short-term survival of acute kidney injury in very elderly men
description	Qinglin Li,1 Meng Zhao,2 Jing Du,1 Xiaodan Wang1 1Department of Geriatric Nephrology, 2Department of Clinical Data Repository, Chinese People’s Liberation Army General Hospital, Beijing, China Objectives: A delayed nephrology consultation (NC) may be associated with a poor prognosis in acute kidney injury (AKI) patients. The aims of this study were to compare the clinical and laboratory characteristics of elderly AKI patients evaluated and not evaluated by nephrologists and to generate a hypothesis regarding the relationship between the timing of the NC and 90-day outcomes. Methods: From 2007 to 2015, this study explored associations among the presence and timing of NC with the non-intensive care unit stay and 90-day mortality in elderly AKI patients at the Geriatric Department of the Chinese People’s Liberation Army General Hospital. Early NC and delayed NC were defined as NCs performed before and 2 days after the day of AKI diagnosis, respectively. Multivariable logistic regression was used to adjust for confounding and selection bias. Results: In total, 623 patients were included for the final analysis, of whom 162 (26%) were evaluated by nephrologists. The 90-day mortality rate was 33.2%, and dialysis was required in 1.4% of patients (9/623). Multivariable analysis showed that a higher prevalence of preexisting chronic obstructive pulmonary disease, AKI diagnosis time, peak serum creatinine level, blood urea nitrogen level, AKI stage, and mortality was associated with the NC. The NC was delayed (>48 h) in 59 patients (36.4%) (median time to consultation, 4 days). The median AKI diagnosis time, presence of oliguria, uric acid level, and a more severe AKI stage were associated with delayed consultation. Moreover, delayed consultation presented a similar 90-day mortality rate to that of an early NC (50.8% vs 44.7%, respectively, P=0.448). Conclusion: In very elderly AKI patients, those evaluated by nephrologists have more severe AKI and a higher mortality rate than those not evaluated by nephrologists. An earlier NC may not be associated with improved 90-day survival. Keywords: acute kidney injury, very elderly, mortality, nephrology consultation, risk factors, outcomes
format	article
author	Li Q Zhao M Du J Wang X
author_facet	Li Q Zhao M Du J Wang X
author_sort	Li Q
title	Earlier nephrology consultation may not be associated with improved short-term survival of acute kidney injury in very elderly men
title_short	Earlier nephrology consultation may not be associated with improved short-term survival of acute kidney injury in very elderly men
title_full	Earlier nephrology consultation may not be associated with improved short-term survival of acute kidney injury in very elderly men
title_fullStr	Earlier nephrology consultation may not be associated with improved short-term survival of acute kidney injury in very elderly men
title_full_unstemmed	Earlier nephrology consultation may not be associated with improved short-term survival of acute kidney injury in very elderly men
title_sort	earlier nephrology consultation may not be associated with improved short-term survival of acute kidney injury in very elderly men
publisher	Dove Medical Press
publishDate	2016
url	https://doaj.org/article/7ba8770610de43bc84ec455eb6044542
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Earlier nephrology consultation may not be associated with improved short-term survival of acute kidney injury in very elderly men

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