Acute Kidney Injury in Elderly subjects Hospitalized for Pneumonia: incidence and predictors for in-hospital mortality

Background: Pneumonia is a significant health problem, especially in elderly, where it is associated with higher mortality and morbidity. Similarly acute kidney injury (AKI) had major impact in the overall outcome of hospitalized patients. The development of AKI in elderly with pneumonia suggested to have a worse outcome. However, previous results are heterogenous. The current work was designed to retrospectively estimate the incidence of AKI in hospitalized elderly subjects with pneumonia. Methodology: Files with complete data of 92 elderly patients hospitalized for Pneumonia were checked for collection of data. The main outcomes were the development of acute kidney injury (primary outcome) and associated in hospital mortality (secondary outcome. The collected data included patient demographics, laboratory data and outcome. Results: The incidence of AKI was 33.7%. the minimum age was 66 years, with slight increase of males than females. No significant differences were found for patient demographics or individual comorbid diseases. However, overall patients with morbidity were significantly higher in AKI than non-AKI groups (90.3% vs 68.9%, respectively, p < 0.05). AKI was significantly associated with anemia, higher WBCs count, higher urea and creatinine. But with lower estimated glomerular filtration rate (eGFR). The total rate of in hospital mortality was 27.2% with significant increase of mortality in AKI than non-AKI groups (41.9% vs 19.7%, respectively). Mortality in AKI was associated with anemia, sepsis, hypertension, diabetes mellitus, ischemic heart disease and cerebrovascular accidents, higher serum urea and creatinine. But with lower eGFR. With multiple regression, ischemic heart disease and lower eGFR are the main predictors (associates) of mortality in AKI. Conclusion: elderly subjects with pneumonia had a higher incidence of Acute kidney injury. The presence of associated comorbid conditions (specifically, ischemic heart diseases) and impaired renal functions were the main predictors of in-hospital mortality among those patients