Acute Kidney Injury in Elderly Patients in Saudi Arabia: Retrospective Study

Introduction: Controlling risk factors for acute kidney failure (AKI) in the elderly is crucial for preventing its occurrence, progression, and complications. Therefore, this study aims to identify risk factors that may increase the likelihood of AKI in elderly patients in Saudi Arabia. Method: A retrospective observational study was conducted involving elderly patients aged 65 years and older who were hospitalized with a diagnosis of acute kidney injury (AKI). The diagnosis of AKI was identified according to the KDIGO guidelines (Kidney Disease Improving Global Outcomes). Patient demographics were analysed to identify potential risk factors associated with AKI. The study also assessed the proportion of AKI causes, the number of patients requiring renal replacement therapy, and the associated mortality rate. Results: The study included a total of 97 patients. The most common risk factors were hypertension (n = 78, 80.41%), anemia (n = 73, 75.26%), diabetes mellitus (n = 68, 70.10%), hypocalcemia (n = 34, 35.05%), chronic kidney disease (n = 32, 32.99%), ischemic heart disease (n = 27, 27.84%), heart failure (n = 26, 26.80%), cerebrovascular events (n = 14, 14.43%), cancer (n = 13, 13.40%), and atrial fibrillation (n = 12, 12.37%). The most frequent causes of AKI, regardless of whether it developed in the hospital or the community, were comorbidities (29%), infections (25%), and medications (19%). Among hospitalized patients, medications (40%) were the most common cause, while among community-acquired cases, comorbidities (44%) were predominant. A small proportion of patients required dialysis following AKI (n = 20). Death occurred in 19 patients, with a median duration of nine days (IQR: 1–12) from AKI onset to death. The cause of AKI was significantly associated with overall mortality ( p = 0.001), with the highest mortality observed in patients whose AKI was infection-related (45.8%). Additionally, the use of furosemide was statistically associated with a lower mortality rate compared to those who did not receive it ( p = 0.04). Conclusion: AKI in elderly patients in Saudi Arabia is a significant clinical problem, with comorbidities like hypertension, anemia, and diabetes being key risk factors. Infection-related AKI is linked to higher mortality, while furosemide use may improve outcomes. Further large scale studies are needed to confirm these findings and guide prevention strategies.