Acute Kidney Injury in the Elderly: An Emerging Crisis in Tertiary Care

Background: Acute Kidney Injury (AKI) is increasingly common among the elderly, often complicated by multiple comorbidities and higher risk of poor outcomes. Understanding this subgroup is critical for optimizing care. Objective: To analyze the clinical profile, etiologies, staging, and short-term outcomes of AKI in patients aged >65 years admitted in a tertiary care hospital. Methods: Subgroup analysis of a prospective observational study including patients aged >65 years who fulfilled KDIGO criteria for AKI. Data on demographics, clinical features, etiologies, AKI staging, comorbidities, dialysis requirements, and outcomes were assessed. Results: Out of 69 patients with AKI, 22 (31.9%) were aged >69 years. Among them, 68.2% were male. Hypertension (63.6%) and diabetes (54.5%) were the most common comorbidities. The predominant symptoms included vomiting (63.6%) and hematuria (59.1%). Sepsis (45.5%) and dehydration (36.4%) were leading etiologies. Most patients (59.1%) presented in Stage III AKI. Dialysis was required in 54.5% of elderly patients. Only 27.3% recovered fully, while 36.4% had partial recovery, and 36.4% deteriorated. As shown in Figure 1, the majority of patients presented in Stage III AKI. Recovery outcomes are illustrated in Figure 2. Etiological factors are summarized in Table 1. Conclusion: AKI in the elderly is common and associated with higher dialysis needs and poorer outcomes. Proactive geriatric-focused AKI management is essential.