Predictors of dialysis adequacy in elderly renal patients with acute kidney injury
DOI:
https://doi.org/10.5281/zenodo.22812960Keywords:
acute kidney injury, dialysis adequacy, elderly, Kt/V, renal replacement therapyAbstract
Background: Dialysis-requiring acute kidney injury (AKI) is common in elderly patients, yet the delivered-dose targets validated in chronic hemodialysis are not well characterized in this population [17,16].
Objective: To describe the proportion of elderly AKI patients achieving adequate dialysis by Kt/V-based criteria and to identify independent predictors of inadequate dialysis.
Methods: In a retrospective cohort of 318 patients aged 65 years or older with dialysis-requiring AKI, single-pool Kt/V and urea reduction ratio were calculated for 2,046 hemodialysis sessions, and predictors of overall inadequate dialysis were identified by multivariable logistic regression [15,14].
Findings: 38.7% of patients had overall inadequate dialysis; non-tunneled vascular access, intradialytic hypotension, hypoalbuminemia, and high ultrafiltration rate independently predicted inadequacy, while residual urine output was protective, and chronological age was not independently predictive [20,19,22].
Conclusions: Dialysis adequacy in elderly AKI patients is substantially modifiable through vascular access selection, hemodynamic tolerance, and individualized ultrafiltration targets, rather than being fixed by age itself.
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