Acute kidney injury in elderly patients in Saudi Arabia: Retrospective single-center study

Abstract Introduction Controlling contributing factors for acute kidney injury (AKI) in the elderly is crucial to prevent its occurrence, progression, and complications. This study aimed to identify factors associated with AKI and to describe its causes, outcomes, and mortality among elderly patients in Saudi Arabia. Method A retrospective observational study was conducted among patients aged 65 years and older who were hospitalized with a diagnosis of AKI at King Saud University Medical City, Riyadh. The diagnosis of AKI was determined according to the Kidney Disease: Improving Global Outcomes (KDIGO) criteria. Demographic, clinical, and laboratory data were reviewed to identify potential factors. The causes of AKI, the need for renal replacement therapy, and associated mortality were also analysed. Results A total of 97 patients were included. The most common contributing factors were hypertension (80.4%), anemia (75.3%), and diabetes mellitus (70%). The leading causes of AKI were comorbidities (28.9%), infections (24.7%), and medications (18.6%). Among hospitalized patients, medications (36.84%) were the predominant cause, whereas comorbidities (23.7%) were more common in community-acquired cases. Mortality was highest in infection-related AKI (45.8%, p = 0.001) and lowest among those receiving furosemide (9% vs. 26%, p = 0.04) or with preexisting heart failure (3.8% vs. 25.4%, p = 0.025). On multivariate analysis, infection-related AKI independently predicted mortality (OR 5.9, p = 0.007), while furosemide use was protective (OR 0.25, p = 0.038). Approximately one-fifth (20.6%) required dialysis, and 67% achieved renal recovery at three months. Conclusion AKI in elderly patients represents a significant clinical concern in Saudi Arabia. Comorbidities such as hypertension, anemia, and diabetes were the predominant factors. AKI was associated with poor outcomes, as approximately one-fifth of patients required dialysis and a similar proportion died during hospitalization. Mortality was significantly higher in infection-related AKI, whereas furosemide use and preexisting heart failure were associated with improved survival.