Acute renal failure in elderly patients

Patients' age and severity of renal insufficiency are important factors in the prognosis of ARF. We analysed, retrospectively, 66 patients over 65 years of age with ARF and requirement of renal function replacement. Mean age was 74.8±7 years. The etiologies of ARF were: obstructive (59%), medical (32%) and surgical (9%). Univariate analysis was undertaken. Hypotension (p=0.005), left ventricular failure (p=0.03), bleeding diathesis (p=0.007) and gastrointestinal haemorrhage (p=0.01) affected prognosis adversely. Mortality was directly related to the number of risk factors (p=0.001) and to the etiology of ARF-obstructive disease had a favorable prognosis (p=0.001). The overall mortality was 34.8% and the main causes of death were cardiovascular (30.4%) and infection (26.1%). Although it is important to define prognostic factors, old age should not be used as a criterion to refuse an opportunity of therapy in ARF.