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Acute Kidney Injury in Older Adults (R01): PA-13-141

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Also see: Acute Kidney Injury in Older Adults (R03): PA-13-142

Also see: Acute Kidney Injury in Older Adults (R21): PA-13-143

Components of Participating Organizations

National Institute on Aging

National Institute of Diabetes and Digestive and Kidney Diseases

Application Receipt/Submission Date(s): Multiple dates, see announcement.

Among all age groups, older adults are the most vulnerable to develop acute kidney injury (AKI), defined as a precipitous decline in glomerular filtration rate (GFR). Overall AKI incidence has increased over the past decades, and the rate has grown fastest in those over 75 years old, who also comprise the most rapidly expanding age group in the U.S. population. Several factors likely contribute to this rise in AKI incidence including more aggressive surgical and medical treatments, increasing numbers of chronic and comorbid illnesses, greater use of nephrotoxic medications and imaging agents, aging of the population, and longer exposure to chronic diseases and nephrotoxins, all of which may be associated with direct or vascular-related kidney injury. Older adults are particularly vulnerable to most of these insults, which, in addition to age-related changes in kidney structure and function, renders these individuals highly susceptible to both AKI onset and the most adverse associated outcomes. Compared to younger AKI patients, older persons who develop AKI have higher rates of short- and long-term mortality, subsequent chronic kidney disease (CKD) including end-stage renal disease (ESRD), prolonged hospital stays, transitions to sub-acute care facilities, AKI-related morbidity, functional decline and related health-care costs. These data, mainly derived from cohorts that may underdiagnose AKI in seniors and have limited follow-up, likely underestimate the magnitude of this trend. Clarification of epidemiologic trends, etiology, additional risk factors, impact of CKD on AKI, as well as identification of high-risk groups and predictors of short- and long-term outcomes of AKI in older adults may lead to earlier and improved prevention, diagnostic and …

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