15 Sepsis was defined according to the Surviving Sepsis Campaign Bundle: 2018 update. 14 The baseline Scr level was the most recent measure taken in the 1–3 months before admission for AKI. 13 The CKD Epidemiology Collaboration method was used to calculate the baseline estimated glomerular filtration rate (eGFR). The 2012 KDIGO-defined Scr criteria were used to identify and classify AKI. The exclusion criteria were as follows: patients who had been previously diagnosed with chronic kidney disease (CKD), a hospital stay < 48 h, patients with no Scr data or only one Scr test, patients with insufficient medical records, and patients who died within 48 h of admission. Other laboratory data of interest included baseline serum creatinine (Scr) level, the Scr level at the time of AKI diagnosis, and the levels of blood urea nitrogen (BUN), uric acid, blood glucose (BG), electrolytes (K, Ca, P, and Mg), C-reactive protein (CRP), albumin, prealbumin, and hemoglobin. Baseline serum sodium levels, and the sodium level at the time of AKI diagnosis were recorded. All admissions were screened and evaluated for AKI and categorized according to the Kidney Disease: Improving Global Outcomes (KDIGO) criteria.ĭemographic and basic data were obtained from the medical records. This study was conducted in accordance with the declaration of Helsinki. The patients’ information were anonymous and non identifiable. The requirement to obtain written informed consent from each patient was waived because this was an observational retrospective study. The study design was approved by the Clinical Ethics Committee of the Chinese PLA General Hospital (number: S2017–054-01). All patients aged ≥ 75 years with normal renal function who were admitted to general ward between January 2007 and December 2018 were enrolled. This was a retrospective observational study conducted at the Chinese PLA General Hospital National Clinical Research Center for Geriatric Diseases (Beijing, China). Therefore, identifying the clinically significant normal ranges of serum sodium is an important issue for clinicians when making decisions regarding elderly AKI patients with dysnatremia. In addition, the normal ranges of serum sodium levels that are applicable to such patients are still unknown. 12 However, the independent or synergistic prognostic effects of abnormal serum sodium levels remain less well studied among elderly AKI patients. 12 Recently, Gao reported that compared with the reference group (136.0–144.9 mmol/L), AKI patients at the time of hospital admission with hyponatremia (< 136.0 mmol/L) or hypernatremia (≥145.0 mmol/L) had higher 90-day mortality rates. The kidneys play a central role in sodium homeostasis, and their functional decline leads to electrolyte disorders. 9, 10 However, little work has been done on investigating electrolyte imbalances in elderly AKI patients, such as dysnatremia and its association with mortality. 7, 8 Previous studies of AKI in the elderly population mostly examined all-cause mortality, renal prognosis, or cardiovascular events. 4–6 Aging kidneys undergoing structural and functional changes that decrease autoregulatory capacity, systemic vasculature, and the immunological system render the elderly population highly susceptible to AKI. 1–3 The disorder is generally characterized by an abrupt deterioration in renal function (RF) that disrupts metabolic, electrolyte and fluid homeostasis over a period of hours to days. In total, 744 patients were suitable for the final evaluation.
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