Causes and Prognosis of Acute Renal Failure in Elderly Patients

In this retrospective study, 287 patients with acute renal failureobserved between 1980 and 1985 were divided into 2 groups, accordingto age: group 1 of 65 years or more (n = 100) and group 2 between17 and 64 years (n = 187). In both age groups the whole spectrumof causes of acute renal failure was found, but within thatspectrum a higher incidence of post-renal failure, acute renalvascular disease and of hypovolaemic acute renal failure wasnoted in group 1 versus group 2. On the other hand, pigment-inducedacute renal failure was lower in group 1 (4%) versus group 2(13%). The overall survival was 54% in the elderly versus 56% in theyounger patients (NS). A close relationship between survivaland the number of postadmission complications was found in bothgroups. Interestingly, the presence of severe hypokalaemia (<3.5mmmol/l) and metabolic alkalosis (plasma HCO₃>30 mmol/l)was associated with a very high mortality of 73% and 86% respectivelyin the elderly patients. Complete or incomplete recovery ofrenal function was the same in both age groups. It is concludedthat age alone should not be used as a discriminating factorin therapeutic decisions concerning acute renal failure in anolder patient.