Acute Kidney Injury in Elderly Patients in Saudi Arabia: Retrospective Study

Acute Kidney Injury in Elderly Patients in Saudi Arabia: Retrospective Study | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Acute Kidney Injury in Elderly Patients in Saudi Arabia: Retrospective Study Abrar Alshehri, Nouf Al-Otaibi, Abdulaziz Alhossan This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-7093452/v1 This work is licensed under a CC BY 4.0 License Status: Under Review Version 1 posted 13 You are reading this latest preprint version Abstract Introduction: Controlling risk factors for acute kidney failure (AKI) in the elderly is crucial for preventing its occurrence, progression, and complications. Therefore, this study aims to identify risk factors that may increase the likelihood of AKI in elderly patients in Saudi Arabia. Method: A retrospective observational study was conducted involving elderly patients aged 65 years and older who were hospitalized with a diagnosis of acute kidney injury (AKI). The diagnosis of AKI was identified according to the KDIGO guidelines (Kidney Disease Improving Global Outcomes). Patient demographics were analysed to identify potential risk factors associated with AKI. The study also assessed the proportion of AKI causes, the number of patients requiring renal replacement therapy, and the associated mortality rate. Results: The study included a total of 97 patients. The most common risk factors were hypertension (n = 78, 80.41%), anemia (n = 73, 75.26%), diabetes mellitus (n = 68, 70.10%), hypocalcemia (n = 34, 35.05%), chronic kidney disease (n = 32, 32.99%), ischemic heart disease (n = 27, 27.84%), heart failure (n = 26, 26.80%), cerebrovascular events (n = 14, 14.43%), cancer (n = 13, 13.40%), and atrial fibrillation (n = 12, 12.37%). The most frequent causes of AKI, regardless of whether it developed in the hospital or the community, were comorbidities (29%), infections (25%), and medications (19%). Among hospitalized patients, medications (40%) were the most common cause, while among community-acquired cases, comorbidities (44%) were predominant. A small proportion of patients required dialysis following AKI (n = 20). Death occurred in 19 patients, with a median duration of nine days (IQR: 1–12) from AKI onset to death. The cause of AKI was significantly associated with overall mortality ( p = 0.001), with the highest mortality observed in patients whose AKI was infection-related (45.8%). Additionally, the use of furosemide was statistically associated with a lower mortality rate compared to those who did not receive it ( p = 0.04). Conclusion: AKI in elderly patients in Saudi Arabia is a significant clinical problem, with comorbidities like hypertension, anemia, and diabetes being key risk factors. Infection-related AKI is linked to higher mortality, while furosemide use may improve outcomes. Further large scale studies are needed to confirm these findings and guide prevention strategies. Acute Elderly Failure Injury Kidney Renal. 1. Introduction Hospitalized patients, especially elderly, are particularly susceptible to developing acute kidney injury (AKI). This condition results in an acute deterioration of renal function within a few hours or days. According to the Kidney Disease Improving Global Outcomes (KDIGO) criteria, AKI is defined by any of the following: a rise in serum creatinine (SCr) of ≥ 0.3 mg/dL (≥ 26.5 µmol/L) within 48 hours, an increase in SCr to at least 1.5 times the baseline within the previous 7 days, or urine output below 0.5 ml/kg/h for a minimum of 6 hours (Khwaja, 2012 ). AKI is not only common in elderly patients admitted to the Intensive Care Unit (ICU), but remains frequent even among elderly patients who are not critically ill (Hoste et al., 2015 ; Sousa et al., 2020 ; Xu et al., 2021 ). Advanced age, the presence of comorbidities, elevated baseline SCr levels, and undergoing cardiac surgery have been identified as significant risk factors for the development of AKI in Saudi population (Alhamad et al., 2023 ; Alkhunaizi et al., 2011 ; Farooqui et al., 2021 ). One study examining 25,120 ICU patients aged 55 years and older found that individuals aged 75 and above were at increased risk of developing AKI and exhibited worse long-term outcomes after receiving renal replacement therapy compared to younger patients (Kane-Gill et al., 2015 ). Moreover, several studies have reported that AKI in elderly individuals is associated with a greater risk of death during hospitalization (Farooqui et al., 2021 ; Hoste et al., 2015 ; Sousa et al., 2020 ). The proportion of elderly individuals is expected to double by 2030, reaching approximately 20% of the population (Jeannotte & Moore, 2007 ). The incidence of AKI rises sharply with advancing age. Elderly patients, particularly those with preexisting chronic kidney disease (CKD), are at markedly higher risk for AKI. Several pathophysiologic elements play a role behind the increase of susceptibility to AKI in the elderly population. These include reduced renal plasma flow, which alters kidney function and impairs the kidney’s ability to adapt to acute ischemic events. Additionally, polypharmacy is common among older adults, and when combined with age-related changes in drug pharmacokinetics and pharmacodynamics, it increases the risk of drug-induced nephrotoxicity (Himmelfarb, 2009 ). Although age is a well-established risk factor for kidney injury, it is essential to recognize additional factors that contribute to its development beyond the effects of aging alone. A better understanding of the risk factors specific to the elderly population may enable more effective prevention and management strategies. However, data regarding risk factors for AKI specifically affecting older adults remain limited in the primary literature and clinical guidelines. Therefore, this study aims to explore the underlying risk factors contributing to AKI in elderly patients in Saudi Arabia and to evaluate the associated morbidity and mortality rates within three months of AKI onset. 2. Methods 2.1. Study design, settings, and participants This retrospective observational study was carried out at King Saud University Medical City (KSUMC) at Riyadh, Saudi Arabia. To be included in the study, patients had to be aged 65 years or older, in accordance with the World Health Organization’s (WHO) definition of geriatric, who admitted with a diagnosis of AKI and had a baseline creatinine clearance (CrCl) of ≥ 60 ml/min. Data were collected from patients admitted to the hospital between January 1, 2016, and December 31, 2018. Exclusion criteria include patients under 65 years of age, receiving either hemodialysis or peritoneal dialysis, or patients who had previously undergone a kidney transplantation. 2.2. Data Collection methods, instruments used, measurements. Data collection was conducted using electronic medical records. Patients’ basic information, laboratory test results, and medication profiles were reviewed to identify potential risk factors. The diagnosis of AKI was determined based on the KDIGO guideline criteria. The association between exposures across different age groups and the development of AKI was assessed. Patients were then retrospectively evaluated three months after the onset of AKI for recovery to baseline renal function, the need for renal replacement therapy, and mortality. 2.3. Data Management and Analysis Plan Data analysis was performed using the Statistical Package for the Social Sciences (SPSS), version 23. Categorical variables were presented as frequencies and percentages, while numerical variables were summarized using medians and interquartile ranges (IQR) due to non-normal distribution. Associations between mortality and the need for dialysis were examined using the Chi-square test. A p -value of less than 0.05 was considered statistically significant. 2.4. Ethical Considerations Patient data were used exclusively for research purposes, with a coding system implemented to ensure confidentiality. The study received approval from the Institutional Review Board at KSUMC (Approval Number: E-19-4503) and adhered to the principles outlined in the Declaration of Helsinki. As this was a retrospective chart review, the requirement for informed consent was waived. 3. Results Ninety-seven patients were included in the study, with a median age of 72 years (IQR: 63–79). The majority were female (n = 53, 54.64%) and obese (n = 35, 36.08%) (Table 1 ). The median duration of was three days (IQR: 1–5). More than half of the patients (n = 55, 56.70%) experienced AKI lasting one week or less, while fewer patients had AKI lasting more than one week (n = 11, 11.34%) or two weeks (n = 31, 31.96%). AKI was reversible in most cases (n = 65, 67.01%), compared with irreversible cases (n = 32, 32.99%) (Table 2 ). The prevalent risk factors among the included patients are presented in (Supplementary 1). The most common were hypertension (n = 78, 80.41%), anemia (n = 73, 75.26%), diabetes mellitus (n = 68, 70.10%), hypocalcemia (n = 34, 35.05%), chronic kidney disease (n = 32, 32.99%), ischemic heart disease (n = 27, 27.84%), heart failure (n = 26, 26.80%), cerebrovascular accident (n = 14, 14.43%), cancer (n = 13, 13.40%), and atrial fibrillation (n = 12, 12.37%). Additional risk factors are presented in (Table 3 ). The most frequent causes of renal failure are shown in (Supplementary 2). The leading causes were comorbidities (29%), infections (25%), and medications (19%) regardless of whether it was developed in the hospital or in the community. When stratified by setting, medications were the most common cause of hospital-acquired AKI (40%), while comorbidities were the most frequent cause in community-acquired cases (44%). A smaller proportion of patients required dialysis following AKI onset (n = 20, 20.62%) compared to those who did not (n = 77, 79.38%). Death occurred in 19 patients (19.59%), with a median time from AKI to death of nine days (IQR: 1–12) (Table 4 ). Table 5 outlines factors potentially associated with the need for dialysis following AKI. No statistically significant associations were observed between the need for dialysis and age, gender, body mass index, smoking status, anemia, heart failure, dyslipidemia, atrial fibrillation, pulmonary hypertension, hypertension, or diabetes mellitus ( p > 0.05). Table 1 Demographic characteristics. Baseline Characteristic Total (N = 97) Age (years), median (IQR) 72 (79 − 63) Height (cm), median (IQR) 160 (164 − 151) Weight (kg), median (IQR) 72.00 (84.00–60.00) BMI (kg/m 2 ), median (IQR) 27.94 (32.89–23.44) Gender, n (%) Female 53 (54.64) Male 44 (45.36) BMI category, n (%) Normal 27 (27.84) Underweight 3 (3.09) Overweight 27 (27.84) Obese 35 (36.08) Baseline BUN (mmol/L), median (IQR) 8.40 (14.30–5.90) Baseline SCr (mmol/L), median (IQR) 99.00 (140 − 83.00) IQR: Interquartile range, BMI: Body Mass Index, BUN: blood urea nitrogen, SCr: serum creatinine. Table 2 Acute kidney injury related information. Characteristic Total (N = 97) BUN at time of AKI (mmol/L), median (IQR) 15.40 (26.00-10.50) SCr at time of AKI (mmol/L), median (IQR) 183 (310 − 135) BUN to SCr ratio, median (IQR) 19.81 (26.35–15.26) Duration of AKI (days), median (IQR) 3 (5 − 1) Duration of AKI, n (%) 2weeks 31 (31.96) Nature of AKI, n (%) Reversible 65 (67.01) Irreversible 32 (32.99) Dialysis after AKI, n (%) Yes 20 (20.62) No 77 (79.38) Death within hospitalization, n (%) Yes 19 (19.59) No 78 (80.41) Days to death (days), median (IQR) 9 (12 − 1) BUN: blood urea nitrogen, IQR: Interquartile range, AKI: acute kidney injury, SCr: serum creatinine. Table 3 Prevalence of risk factors for acute kidney injury. Characteristic Total (N = 97) Anaemia, n (%). Yes 73 (75.26) No 24 (24.74) Cancer, n (%) Yes 13 (13.40) No 84 (86.60) Hypothyroidism, n (%) Yes 6 (6.19) No 91 (93.81) Gout, n (%) Yes 5 (5.15) No 92 (94.85) Liver disease, n (%) Yes 7 (7.22) No 90 (92.78) Smoking, n (%) Yes 6 (6.19) No 91 (93.81) Cerebrovascular accident, n (%) Yes 14 (14.43) No 83 (85.57) Benign prostatic Hypertrophy, n (%) Yes 7 (7.22) No 37 (38.14) Medication, n (%) Nephrotoxic 10 (10.31) Non nephrotoxic 87 (89.69) Calcium category, n (%) Normal 54 (55.67) Hypercalcemia 9 (9.28) Hypocalcemia 34 (35.05) Heart failure, n (%) Yes 26 (26.80) No 71 (73.20) Atrial fibrillation, n (%) Yes 12 (12.37) No 85 (87.63) Dyslipidaemia, n (%) Yes 19 (19.59) No 78 (80.41) Pulmonary hypertension, n (%) Yes 6 (6.19) No 91 (93.81) Ischemic heart disease, n (%) Yes 27 (27.84) No 70 (72.16) Hypertension, n (%) Yes 78 (80.41) No 19 (19.59) Diabetes mellitus, n (%) Yes 68 (70.10) No 29 (29.90) Chronic Kidney Disease, n (%) Yes 32 (32.99) No 65 (67.01) Other, n (%) PAD 1 (1.03) VTE 2 (2.06) Valvular disease 2 (2.06) None 92 (94.85) VTE: Venous Thromboembolism, PAD: Peripheral Arterial Disease. Table 4 Safety outcomes post-acute kidney injury in elderly patients. Characteristic Total (N = 97) Dialysis after AKI, n (%) Yes 20 (20.62) No 77 (79.38) Death within hospitalization, n (%) Yes 19 (19.59) No 78 (80.41) Days to death (days), median (IQR) 9 (12 − 1) AKI: Acute Kidney Injury, IQR: Interquartile range. Table 5 Factors associated with need of dialysis. Factor Need of dialysis p -value No Yes Age (mean, standard deviation) 73.73 ± 10.46 71.8 ± 9.29 0.455 Gender 0.121 Male 38 (86.4%) 6 (13.6%) Female 39 (73.6%) 14 (26.4%) BMI category 0.455 Normal weight 27 (87.1%) 4 (12.9%) Overweight 21 (75%) 7 (25%) Obese 27 (77.1%) 8 (22.9%) Smoking 0.427 No 73 (80.2%) 18 (19.8%) Yes 4 (66.7%) 2 (33.3%) Anaemia 0.086 No 22 (91.7%) 2 (8.3%) Yes 55 (75.3%) 18 (24.7%) Heart failure 0.181 No 54 (76.1%) 17 (23.9%) Yes 23 (88.5%) 3 (11.5%) Dyslipidemia 0.188 No 64 (82.1%) 14 (17.9%) Yes 13 (68.4%) 6 (31.6%) Atrial fibrillation 0.689 No 68 (80%) 17 (20%) Yes 9 (75%) 3 (25%) Pulmonary hypertension 0.242 No 72 (78.3%) 20 (21.7%) Yes 5 (100%) 0 (0%) Hypertension 0.958 No 15 (78.9%) 4 (21.1%) Yes 62 (79.5%) 16 (26.5%) Diabetes mellitus 0.576 No 22 (75.9%) 7 (24.1%) Yes 55 (80.9%) 13 (19.1%) Acute kidney injury (AKI) reason 0.459 Infection 17 (70.8%) 7 (29.2%) Hypovolemia 12 (92.3%) 1 (7.7%) Medication a 15 (83.3%) 3 (16.7%) Comorbidity b 22 (78.6%) 6 (21.4%) *Significant at level 0.05 a Frusemide, Nonsteroidal anti-inflammatory drugs, Angiotensin-converting enzyme inhibitor, and Angiotensin receptor blocker. b Age, Gender, Body mass index, Smoking, Anemia, Heart failure, Dyslipidemia, Atrial fibrillation, Pulmonary hypertension, Hypertension, and Diabetes mellitus Table 6 Factors associated with number of deaths Factor Death p -value No Yes Age (mean, standard deviation ) 72.51 ± 10.06 76.68 ± 10.44 0.111 Gender 0.751 Male 36 (81.8%) 8 (18.2%) Female 42 (79.2%) 11 (20.8%) BMI category 0.746 Normal weight 25 (80.6%) 6 (19.4%) Overweight 22 (78.6%) 6 (21.4%) Obese 30 (85.7%) 5 (14.3%) Smoking 0.852 No 73 (80.2%) 18 (19.8%) Yes 5 (83.3%) 1 (15.7%) Anaemia 0.109 No 22 (91.7%) 2 (8.3%) Yes 56 (76.7%) 17 (23.3%) Dyslipidaemia 0.642 No 62 (79.5%) 16 (20.5%) Yes 16 (84.2%) 3 (15.8%) Atrial fibrillation 0.785 No 68 (80%) 17 (20%) Yes 10 (83.3%) 2 (16.7%) Pulmonary hypertension 0.257 No 73 (79.3%) 19 (20.7%) Yes 5 (100%) 0 (0%) Hypertension 0.410 No 14 (73.7%) 5 (26.3%) Yes 64 (82.1%) 14 (17.9%) Diabetes mellitus 0.348 No 25 (86.2%) 4 (13.8%) Yes 53 (77.9%) 15 (22.1%) Acute kidney injury (AKI) cause 0.001* Infection 13 (54.2%) 11 (45.8%) Hypovolemia 12 (92.3%) 1 (7.7%) Medication a 15 (83.3%) 3 (16.7%) Comorbidity b 27 (96.4%) 1 (3.6%) Furosemide No Yes 46 (74%) 32 (91%) 16 (26%) 3 (9%) 0.040* Aspirin No Yes 51 (80%) 27 (81%) 13 (20%) 6 (19%) 0.802 *Significant at level 0.05 a Frusemide, Nonsteroidal anti-inflammatory drugs, Angiotensin-converting enzyme inhibitor, and Angiotensin receptor blocker. b Age, Gender, Body mass index, Smoking, Anemia, Heart failure, Dyslipidemia, Atrial fibrillation, Pulmonary hypertension, Hypertension, and Diabetes mellitus. 4. Discussion Controlling risk factors for AKI is essential for preventing its occurrence, progression, and associated complications. Identifying patients at high risk for AKI has become a primary focus of numerous predictive models. However, the effectiveness and accuracy of these models tend to diminish with increasing patient age (Kate et al., 2016 ). Therefore, focusing on reducing risk factors is more effective approach than relying on early prediction of AKI in older adults. In this study, hypertension, anemia, diabetes mellitus, hypocalcemia, and chronic kidney disease were found to be the most frequent risk factors among elderly patients. There is a scarcity of studies focusing on AKI risk factors in the elderly. Harbrecht (2019) explored the risk factors and outcomes of AKI in elderly patients who experienced trauma. They found that male gender, hypotension, and injury in the extremity are the risk factors associated with AKI development. In contrast, hypertension and diabetes did not show association with AKI in the elderly trauma patients (Harbrecht et al., 2019 ). Another study by Jain (2017) identified risk factors for AKI in elderly patients with diabetes and community acquired pneumonia. Their findings indicated that male sex, hypertension, the use of ACE inhibitors (ACEIs) and angiotensin II receptor blockers (ARBs), as well as insulin therapy, were independently associated with an increased risk of AKI in this patient population (Jain et al., 2017 ). In our study however, presence of comorbidities was the most prevalent risk factor in the Saudi population. Consistent with our findings, other studies have reported that comorbidities like diabetes mellitus, hypertension, pre-existing CKD, and elevated bassline SCr levels are significantly associated to the development of AKI (Alhamad et al., 2023 ; Alkhunaizi et al., 2011 ; Farooqui et al., 2021 ). When stratifying patients based on the setting of AKI causes, comorbidities remained the leading risk factor in community-acquired cases. In contrast, among hospitalized patients, medications were the most common contributing factor. The challenging of AKI lies in its association with a high mortality rate, as previously reported (Farooqui et al., 2021 ; Hoste et al., 2015 ; Sousa et al., 2020 ). In our study, nearly one-fifth of the patients who developed AKI died during their hospitalization. In Sousa’s (2020) study of patients over 90 years old, the overall in-hospital mortality was significantly greater in those with AKI compared to those without AKI (66.8% vs. 23.8%), p < 0.001 (Sousa et al., 2020 ). Similarly, elderly Saudi patients had a significantly higher 30-day mortality rate of 40.7% in who developed AKI compared to only 3.7% in those without AKI (Farooqui et al., 2021 ). Moreover, Hoste (2015) found that increasing severity of AKI was linked to significantly higher adjusted odds of hospital mortality by approximately three times greater in Stage 2 and nearly seven times greater in Stage 3 compared to patients without AKI or with less severe disease (Hoste et al., 2015 ). In our study, we found a significant association between the cause of AKI and overall mortality. The highest mortality rate (45.8%) occurred in patients with infection-related AKI, which consistent with previous findings (Pan et al., 2016 ; Silver et al., 2018 ; Vandijck et al., 2007 ). Additionally, we found that the use of furosemide was statistically associated with lower mortality compared to non-use ( p -value = 0.04). Our results align with a study by Zhao (2020), which demonstrated that furosemide use in critically ill patients with AKI was associated with enhanced short-term survival and improved renal function recovery (Zhao et al., 2020 ). However, a systematic review and meta-analysis by Krzych and Czempik ( 2019 ) did not find a consistent mortality benefit from furosemide use, except in cases of contrast-induced AKI (Krzych & Czempik, 2019 ). Progression to end-stage renal disease (ESRD), requiring renal replacement therapy, is another significant consequence of AKI. In our sample, one in five patients required renal replacement therapy. Similarly, Ishani (2009) found that among elderly patients with AKI, the probability of initiating dialysis for ESRD within 30 days was 0.96%, compared to 0.04% in patients without AKI, with the risk increasing steadily after discharge (Ishani et al., 2009 ). In contrast, Hsu (2007) studied the incidence of AKI in the community in Northern California, found that elderly patients who aged 80 years or above are less likely to receive renal replacement therapy despite being more likely to have AKI. They hypothesized that this could be due to the lower likelihood of dialysis being prescribed for elderly patients and greater reluctance among this group to undergo such treatment (Hsu et al., 2007 ). Moreover, hospitalized patients with AKI who required renal replacement therapy experienced significantly higher mortality rates than those who did not undergo such treatment (Alhamad et al., 2023 ; Alkhunaizi et al., 2011 ; Farooqui et al., 2021 ). This study has certain limitations. First, the study was conducted at a single medical center (KSUMC in Riyadh), which may limit the generalizability of the findings to other hospitals or regions, especially rural or under-resourced settings. Second, the small sample size reduced the statistical power of the analysis, leading some results to fall short of significance. For example, no significant association was found between the need for dialysis and any of the examined risk factors, likely due to the limited number of patients requiring replacement therapy. Third, the current study highlights acute renal failure in Saudi elderly and the risk factors prevalent among this group in particular. Therefore, future studies should focus on factors influencing older adults who develop AKI along with a group of healthy older adults. Fourth, the analysis have not controlled for all confounding factors such as fluid balance, infection severity, medication dosages, medication timing, and drug combinations. Fifth, due to its retrospective design, the study was subject to incomplete or missing data from electronic medical records. 5. Conclusion This study highlights the burden of AKI among elderly patients in Saudi Arabia, revealing that common comorbidities such as hypertension, anemia, diabetes mellitus, and chronic kidney disease significantly contribute to AKI development in this population. The findings also indicate a notable association between infection-related AKI and higher mortality rates, while the use of furosemide was associated with improved survival outcomes. Despite these insights, the study's limitations including its retrospective design, small sample size, lack of a healthy control group, and single center setting warrant cautious interpretation of the results. Future research should include larger, multicenter prospective studies with comparative groups to better identify modifiable risk factors and develop effective preventive and management strategies tailored to the elderly. Abbreviations AKI: Acute kidney injury. KDIGO: The Kidney Disease Improving Global Outcomes guidelines. SCr: Serum Creatinine. ICU: Intensive Care Unit. WHO: World Health Organization. Crcl: Creatinine clearance. ESRD: End-stage renal disease. Declarations Supplementary Materials: The following supporting information can be downloaded at: www.xxx.com/xxx, (Online Resource 1): Percentage of risk factors for acute kidney injury in elderly patients; (Online Resource 2): Reason categories of acute kidney injury in the elderly. Author Contributions: Conceptualization, A.Sh and A.A.; methodology, N.A.; software, N.A; validation, A.A., A.Sh; formal analysis, A.Sh and N.A.; investigation, A.Sh; resources, A.Sh ; data curation, A.Sh; writing—original draft preparation, All Authors; writing—review and editing, All Authors; visualization, All Authors; supervision, A.A.; project administration, N.A.; funding acquisition, A.Sh All authors have read and agreed to the published version of the manuscript. Funding: This research received no external funding. Institutional Review Board Statement: The study was conducted in accordance with the Declaration of Helsinki, and approved by the Institutional Review Board (or Ethics Committee) of King Saud University (protocol code 20/031/IRB on 22 January 2020). Informed Consent Statement: Not applicable. Acknowledgments: The authors thank the Deanship of Scientific Research and RSSU at King Saud University for their technical support. Additionally, we would like to extend our appreciation to the Deanship of Scientific Research at King Saud University for their logistical support of this study through the Research Assistant Internship Program. The authors acknowledge SCIBENDI for English editing. Availability of data and materials: Data is available on request due to privacy/ethical restrictions. The data that support the findings of this study are available on request from the corresponding author, [AFA]. 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M., & Kellum, J. A. (2015). Risk factors for acute kidney injury in older adults with critical illness: a retrospective cohort study. American journal of kidney diseases, 65 (6), 860-869. Kate, R. J., Perez, R. M., Mazumdar, D., Pasupathy, K. S., & Nilakantan, V. (2016, Mar 29). Prediction and detection models for acute kidney injury in hospitalized older adults. BMC Med Inform Decis Mak, 16 , 39. https://doi.org/10.1186/s12911-016-0277-4 Khwaja, A. (2012). KDIGO clinical practice guidelines for acute kidney injury. Nephron Clinical Practice, 120 (4), c179-c184. Krzych, Ł. J., & Czempik, P. F. (2019). Impact of furosemide on mortality and the requirement for renal replacement therapy in acute kidney injury: a systematic review and meta-analysis of randomised trials. Annals of Intensive Care, 9 , 1-9. Pan, H., Wu, P., Wu, V., Yang, Y., Huang, T., Shiao, C., Chen, T., Tarng, D., Lin, J., & Yang, W. (2016). Taiwan Consortium for Acute Kidney Injury and Renal Diseases (CAKs): A nationwide survey of clinical characteristics, management, and outcomes of acute kidney injury (AKI)—patients with and without preexisting chronic kidney disease have different prognoses. Medicine (Baltimore), 95 (39), e4987. Silver, S. A., Harel, Z., McArthur, E., Nash, D. M., Acedillo, R., Kitchlu, A., Garg, A. X., Chertow, G. M., Bell, C. M., & Wald, R. (2018). Causes of death after a hospitalization with AKI. Journal of the American Society of Nephrology: JASN, 29 (3), 1001. Sousa, A. L. B., de Souza, L. M., Santana Filho, O. V., e Léda, V. H. F., & Rocha, P. N. (2020, 2020/01/30). Incidence, predictors and prognosis of acute kidney injury in nonagenarians: an in-hospital cohort study. BMC nephrology, 21 (1), 34. https://doi.org/10.1186/s12882-020-1698-y Vandijck, D., Reynvoet, E., Blot, S., Vandecasteele, E., & Hoste, E. (2007). Severe infection, sepsis and acute kidney injury. Acta Clinica Belgica, 62 (sup2), 332-336. Xu, L., Wu, Y., Chen, Y., Li, R., Wang, Z., Li, Z., Liu, G., Yu, L., Shi, W., & Liang, X. (2021, Jan 6). Is acute kidney injury age-dependent in older adults: an observational study in two centers from North China. BMC Geriatr, 21 (1), 7. https://doi.org/10.1186/s12877-020-01906-z Zhao, G.-j., Xu, C., Ying, J.-c., Lü, W.-b., Hong, G.-l., Li, M.-f., Wu, B., Yao, Y.-m., & Lu, Z.-q. (2020). Association between furosemide administration and outcomes in critically ill patients with acute kidney injury. Critical care, 24 , 1-9. Additional Declarations No competing interests reported. Supplementary Files Supplementary10July2025.docx Cite Share Download PDF Status: Under Review Version 1 posted Editorial decision: Revision requested 04 Oct, 2025 Reviews received at journal 03 Oct, 2025 Reviews received at journal 02 Oct, 2025 Reviewers agreed at journal 19 Sep, 2025 Reviewers agreed at journal 19 Sep, 2025 Reviewers agreed at journal 19 Sep, 2025 Reviews received at journal 06 Sep, 2025 Reviewers agreed at journal 20 Aug, 2025 Reviewers agreed at journal 18 Aug, 2025 Reviewers invited by journal 18 Aug, 2025 Editor assigned by journal 11 Aug, 2025 Submission checks completed at journal 11 Aug, 2025 First submitted to journal 08 Aug, 2025 You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-7093452","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":504453404,"identity":"e870344b-1276-4cf5-ae0b-bd84fc99dc97","order_by":0,"name":"Abrar Alshehri","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAA7UlEQVRIiWNgGAWjYDAC5gMMzAwMBxjY2BvAfMYGglrYEqBaeA6QqoVBIoFILfxtzI8/F9TcyeeTfGN4m4fBRnbDAfaHH/BpkTjGZiY949gzyzbpHGNrHoY04w0HeIwl8Fpzv8GMmYftsAGbdI6ZNA/D4USgFga8WuSPsX/+zPMPqEXyDEjLf6AW9sc/8GkxOMZjIM3bBtQiwQPScgCohcEMry2Gx3jKpHn7gFp40oot5xgkG888zGNmgU+L3DH2zZ95vh02kG8/vPHGmwo72b7j7Y9v4NOCAiQYDIAkM9HqwVpGwSgYBaNgFGABAFv3RS1ou6SgAAAAAElFTkSuQmCC","orcid":"","institution":"Umm al-Qura University","correspondingAuthor":true,"prefix":"","firstName":"Abrar","middleName":"","lastName":"Alshehri","suffix":""},{"id":504453405,"identity":"1c645157-4469-4998-8aa2-569e2708ef91","order_by":1,"name":"Nouf Al-Otaibi","email":"","orcid":"","institution":"Umm al-Qura University","correspondingAuthor":false,"prefix":"","firstName":"Nouf","middleName":"","lastName":"Al-Otaibi","suffix":""},{"id":504453406,"identity":"24ed05d8-572c-4399-9e01-c7392a218892","order_by":2,"name":"Abdulaziz Alhossan","email":"","orcid":"","institution":"King Saud University","correspondingAuthor":false,"prefix":"","firstName":"Abdulaziz","middleName":"","lastName":"Alhossan","suffix":""}],"badges":[],"createdAt":"2025-07-10 13:23:08","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-7093452/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-7093452/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":89847200,"identity":"2c936c19-7690-4624-8af3-ca4231c10baa","added_by":"auto","created_at":"2025-08-25 16:41:57","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":914557,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-7093452/v1/ac4fddfa-5214-4b8d-a0cb-fcb14029192a.pdf"},{"id":89846796,"identity":"c208ee82-ee46-4479-9574-7a263066ceec","added_by":"auto","created_at":"2025-08-25 16:25:11","extension":"docx","order_by":0,"title":"","display":"","copyAsset":false,"role":"supplement","size":74647,"visible":true,"origin":"","legend":"","description":"","filename":"Supplementary10July2025.docx","url":"https://assets-eu.researchsquare.com/files/rs-7093452/v1/4ec554c03e1466b01384f2c6.docx"}],"financialInterests":"No competing interests reported.","formattedTitle":"Acute Kidney Injury in Elderly Patients in Saudi Arabia: Retrospective Study","fulltext":[{"header":"1. Introduction","content":"\u003cp\u003eHospitalized patients, especially elderly, are particularly susceptible to developing acute kidney injury (AKI). This condition results in an acute deterioration of renal function within a few hours or days. According to the Kidney Disease Improving Global Outcomes (KDIGO) criteria, AKI is defined by any of the following: a rise in serum creatinine (SCr) of \u0026ge;\u0026thinsp;0.3 mg/dL (\u0026ge;\u0026thinsp;26.5 \u0026micro;mol/L) within 48 hours, an increase in SCr to at least 1.5 times the baseline within the previous 7 days, or urine output below 0.5 ml/kg/h for a minimum of 6 hours (Khwaja, \u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e2012\u003c/span\u003e).\u003c/p\u003e\u003cp\u003eAKI is not only common in elderly patients admitted to the Intensive Care Unit (ICU), but remains frequent even among elderly patients who are not critically ill (Hoste et al., \u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e2015\u003c/span\u003e; Sousa et al., \u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e2020\u003c/span\u003e; Xu et al., \u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e2021\u003c/span\u003e). Advanced age, the presence of comorbidities, elevated baseline SCr levels, and undergoing cardiac surgery have been identified as significant risk factors for the development of AKI in Saudi population (Alhamad et al., \u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e2023\u003c/span\u003e; Alkhunaizi et al., \u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2011\u003c/span\u003e; Farooqui et al., \u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e2021\u003c/span\u003e). One study examining 25,120 ICU patients aged 55 years and older found that individuals aged 75 and above were at increased risk of developing AKI and exhibited worse long-term outcomes after receiving renal replacement therapy compared to younger patients (Kane-Gill et al., \u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e2015\u003c/span\u003e). Moreover, several studies have reported that AKI in elderly individuals is associated with a greater risk of death during hospitalization (Farooqui et al., \u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e2021\u003c/span\u003e; Hoste et al., \u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e2015\u003c/span\u003e; Sousa et al., \u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e2020\u003c/span\u003e).\u003c/p\u003e\u003cp\u003eThe proportion of elderly individuals is expected to double by 2030, reaching approximately 20% of the population (Jeannotte \u0026amp; Moore, \u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e2007\u003c/span\u003e). The incidence of AKI rises sharply with advancing age. Elderly patients, particularly those with preexisting chronic kidney disease (CKD), are at markedly higher risk for AKI. Several pathophysiologic elements play a role behind the increase of susceptibility to AKI in the elderly population. These include reduced renal plasma flow, which alters kidney function and impairs the kidney\u0026rsquo;s ability to adapt to acute ischemic events. Additionally, polypharmacy is common among older adults, and when combined with age-related changes in drug pharmacokinetics and pharmacodynamics, it increases the risk of drug-induced nephrotoxicity (Himmelfarb, \u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e2009\u003c/span\u003e).\u003c/p\u003e\u003cp\u003eAlthough age is a well-established risk factor for kidney injury, it is essential to recognize additional factors that contribute to its development beyond the effects of aging alone. A better understanding of the risk factors specific to the elderly population may enable more effective prevention and management strategies. However, data regarding risk factors for AKI specifically affecting older adults remain limited in the primary literature and clinical guidelines. Therefore, this study aims to explore the underlying risk factors contributing to AKI in elderly patients in Saudi Arabia and to evaluate the associated morbidity and mortality rates within three months of AKI onset.\u003c/p\u003e"},{"header":"2. Methods","content":"\u003cdiv id=\"Sec3\" class=\"Section2\"\u003e\u003ch2\u003e2.1. Study design, settings, and participants\u003c/h2\u003e\u003cp\u003eThis retrospective observational study was carried out at King Saud University Medical City (KSUMC) at Riyadh, Saudi Arabia. To be included in the study, patients had to be aged 65 years or older, in accordance with the World Health Organization\u0026rsquo;s (WHO) definition of geriatric, who admitted with a diagnosis of AKI and had a baseline creatinine clearance (CrCl) of \u0026ge;\u0026thinsp;60 ml/min. Data were collected from patients admitted to the hospital between January 1, 2016, and December 31, 2018. Exclusion criteria include patients under 65 years of age, receiving either hemodialysis or peritoneal dialysis, or patients who had previously undergone a kidney transplantation.\u003c/p\u003e\u003c/div\u003e\u003cdiv id=\"Sec4\" class=\"Section2\"\u003e\u003ch2\u003e2.2. Data Collection methods, instruments used, measurements.\u003c/h2\u003e\u003cp\u003eData collection was conducted using electronic medical records. Patients\u0026rsquo; basic information, laboratory test results, and medication profiles were reviewed to identify potential risk factors. The diagnosis of AKI was determined based on the KDIGO guideline criteria. The association between exposures across different age groups and the development of AKI was assessed. Patients were then retrospectively evaluated three months after the onset of AKI for recovery to baseline renal function, the need for renal replacement therapy, and mortality.\u003c/p\u003e\u003c/div\u003e\u003cdiv id=\"Sec5\" class=\"Section2\"\u003e\u003ch2\u003e2.3. Data Management and Analysis Plan\u003c/h2\u003e\u003cp\u003eData analysis was performed using the Statistical Package for the Social Sciences (SPSS), version 23. Categorical variables were presented as frequencies and percentages, while numerical variables were summarized using medians and interquartile ranges (IQR) due to non-normal distribution. Associations between mortality and the need for dialysis were examined using the Chi-square test. A \u003cem\u003ep\u003c/em\u003e-value of less than 0.05 was considered statistically significant.\u003c/p\u003e\u003c/div\u003e\u003cdiv id=\"Sec6\" class=\"Section2\"\u003e\u003ch2\u003e2.4. Ethical Considerations\u003c/h2\u003e\u003cp\u003ePatient data were used exclusively for research purposes, with a coding system implemented to ensure confidentiality. The study received approval from the Institutional Review Board at KSUMC (Approval Number: E-19-4503) and adhered to the principles outlined in the Declaration of Helsinki. As this was a retrospective chart review, the requirement for informed consent was waived.\u003c/p\u003e\u003c/div\u003e"},{"header":"3. Results","content":"\u003cp\u003eNinety-seven patients were included in the study, with a median age of 72 years (IQR: 63\u0026ndash;79). The majority were female (n\u0026thinsp;=\u0026thinsp;53, 54.64%) and obese (n\u0026thinsp;=\u0026thinsp;35, 36.08%) (Table\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e). The median duration of was three days (IQR: 1\u0026ndash;5). More than half of the patients (n\u0026thinsp;=\u0026thinsp;55, 56.70%) experienced AKI lasting one week or less, while fewer patients had AKI lasting more than one week (n\u0026thinsp;=\u0026thinsp;11, 11.34%) or two weeks (n\u0026thinsp;=\u0026thinsp;31, 31.96%). AKI was reversible in most cases (n\u0026thinsp;=\u0026thinsp;65, 67.01%), compared with irreversible cases (n\u0026thinsp;=\u0026thinsp;32, 32.99%) (Table\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e). The prevalent risk factors among the included patients are presented in (Supplementary 1). The most common were hypertension (n\u0026thinsp;=\u0026thinsp;78, 80.41%), anemia (n\u0026thinsp;=\u0026thinsp;73, 75.26%), diabetes mellitus (n\u0026thinsp;=\u0026thinsp;68, 70.10%), hypocalcemia (n\u0026thinsp;=\u0026thinsp;34, 35.05%), chronic kidney disease (n\u0026thinsp;=\u0026thinsp;32, 32.99%), ischemic heart disease (n\u0026thinsp;=\u0026thinsp;27, 27.84%), heart failure (n\u0026thinsp;=\u0026thinsp;26, 26.80%), cerebrovascular accident (n\u0026thinsp;=\u0026thinsp;14, 14.43%), cancer (n\u0026thinsp;=\u0026thinsp;13, 13.40%), and atrial fibrillation (n\u0026thinsp;=\u0026thinsp;12, 12.37%). Additional risk factors are presented in (Table\u0026nbsp;\u003cspan refid=\"Tab3\" class=\"InternalRef\"\u003e3\u003c/span\u003e). The most frequent causes of renal failure are shown in (Supplementary 2). The leading causes were comorbidities (29%), infections (25%), and medications (19%) regardless of whether it was developed in the hospital or in the community. When stratified by setting, medications were the most common cause of hospital-acquired AKI (40%), while comorbidities were the most frequent cause in community-acquired cases (44%). A smaller proportion of patients required dialysis following AKI onset (n\u0026thinsp;=\u0026thinsp;20, 20.62%) compared to those who did not (n\u0026thinsp;=\u0026thinsp;77, 79.38%). Death occurred in 19 patients (19.59%), with a median time from AKI to death of nine days (IQR: 1\u0026ndash;12) (Table\u0026nbsp;\u003cspan refid=\"Tab4\" class=\"InternalRef\"\u003e4\u003c/span\u003e). Table\u0026nbsp;\u003cspan refid=\"Tab5\" class=\"InternalRef\"\u003e5\u003c/span\u003e outlines factors potentially associated with the need for dialysis following AKI. No statistically significant associations were observed between the need for dialysis and age, gender, body mass index, smoking status, anemia, heart failure, dyslipidemia, atrial fibrillation, pulmonary hypertension, hypertension, or diabetes mellitus (\u003cem\u003ep\u003c/em\u003e\u0026thinsp;\u0026gt;\u0026thinsp;0.05).\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab1\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003eDemographic characteristics.\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"2\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u003cp\u003eBaseline Characteristic\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u003cp\u003eTotal\u003c/p\u003e\u003cp\u003e(N\u0026thinsp;=\u0026thinsp;97)\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eAge (years), median (IQR)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e72 (79\u0026thinsp;\u0026minus;\u0026thinsp;63)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eHeight (cm), median (IQR)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e160 (164\u0026thinsp;\u0026minus;\u0026thinsp;151)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eWeight (kg), median (IQR)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e72.00 (84.00\u0026ndash;60.00)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eBMI (kg/m\u003csup\u003e2\u003c/sup\u003e), median (IQR)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e27.94 (32.89\u0026ndash;23.44)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eGender, n (%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eFemale\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e53 (54.64)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eMale\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e44 (45.36)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eBMI category, n (%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eNormal\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e27 (27.84)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eUnderweight\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e3 (3.09)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eOverweight\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e27 (27.84)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eObese\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e35 (36.08)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eBaseline BUN (mmol/L), median (IQR)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e8.40 (14.30\u0026ndash;5.90)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eBaseline SCr (mmol/L), median (IQR)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e99.00 (140\u0026thinsp;\u0026minus;\u0026thinsp;83.00)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003ctfoot\u003e\u003ctr\u003e\u003ctd colspan=\"2\"\u003eIQR: Interquartile range, BMI: Body Mass Index, BUN: blood urea nitrogen, SCr: serum creatinine.\u003c/td\u003e\u003c/tr\u003e\u003c/tfoot\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab2\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 2\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003eAcute kidney injury related information.\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"2\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u003cp\u003eCharacteristic\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u003cp\u003eTotal\u003c/p\u003e\u003cp\u003e(N\u0026thinsp;=\u0026thinsp;97)\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eBUN at time of AKI (mmol/L), median (IQR)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e15.40 (26.00-10.50)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eSCr at time of AKI (mmol/L), median (IQR)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e183 (310\u0026thinsp;\u0026minus;\u0026thinsp;135)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eBUN to SCr ratio, median (IQR)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e19.81 (26.35\u0026ndash;15.26)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eDuration of AKI (days), median (IQR)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e3 (5\u0026thinsp;\u0026minus;\u0026thinsp;1)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eDuration of AKI, n (%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u0026lt;=1week\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e55 (56.70)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e8\u0026ndash;14 days\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e11 (11.34)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u0026gt;\u0026thinsp;2weeks\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e31 (31.96)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eNature of AKI, n (%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eReversible\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e65 (67.01)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eIrreversible\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e32 (32.99)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eDialysis after AKI, n (%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eYes\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e20 (20.62)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eNo\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e77 (79.38)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eDeath within hospitalization, n (%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eYes\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e19 (19.59)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eNo\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e78 (80.41)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eDays to death (days), median (IQR)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e9 (12\u0026thinsp;\u0026minus;\u0026thinsp;1)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003ctfoot\u003e\u003ctr\u003e\u003ctd colspan=\"2\"\u003eBUN: blood urea nitrogen, IQR: Interquartile range, AKI: acute kidney injury, SCr: serum creatinine.\u003c/td\u003e\u003c/tr\u003e\u003c/tfoot\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab3\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 3\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003ePrevalence of risk factors for acute kidney injury.\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"2\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u003cp\u003eCharacteristic\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u003cp\u003eTotal\u003c/p\u003e\u003cp\u003e(N\u0026thinsp;=\u0026thinsp;97)\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eAnaemia, n (%).\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eYes\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e73 (75.26)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eNo\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e24 (24.74)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eCancer, n (%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eYes\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e13 (13.40)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eNo\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e84 (86.60)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eHypothyroidism, n (%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eYes\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e6 (6.19)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eNo\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e91 (93.81)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eGout, n (%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eYes\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e5 (5.15)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eNo\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e92 (94.85)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eLiver disease, n (%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eYes\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e7 (7.22)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eNo\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e90 (92.78)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eSmoking, n (%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eYes\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e6 (6.19)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eNo\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e91 (93.81)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eCerebrovascular accident, n (%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eYes\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e14 (14.43)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eNo\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e83 (85.57)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eBenign prostatic Hypertrophy, n (%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eYes\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e7 (7.22)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eNo\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e37 (38.14)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eMedication, n (%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eNephrotoxic\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e10 (10.31)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eNon nephrotoxic\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e87 (89.69)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eCalcium category, n (%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eNormal\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e54 (55.67)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eHypercalcemia\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e9 (9.28)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eHypocalcemia\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e34 (35.05)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eHeart failure, n (%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eYes\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e26 (26.80)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eNo\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e71 (73.20)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eAtrial fibrillation, n (%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eYes\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e12 (12.37)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eNo\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e85 (87.63)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eDyslipidaemia, n (%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eYes\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e19 (19.59)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eNo\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e78 (80.41)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003ePulmonary hypertension, n (%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eYes\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e6 (6.19)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eNo\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e91 (93.81)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eIschemic heart disease, n (%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eYes\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e27 (27.84)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eNo\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e70 (72.16)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eHypertension, n (%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eYes\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e78 (80.41)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eNo\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e19 (19.59)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eDiabetes mellitus, n (%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eYes\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e68 (70.10)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eNo\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e29 (29.90)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eChronic Kidney Disease, n (%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eYes\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e32 (32.99)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eNo\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e65 (67.01)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eOther, n (%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003ePAD\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e1 (1.03)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eVTE\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e2 (2.06)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eValvular disease\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e2 (2.06)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eNone\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e92 (94.85)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003ctfoot\u003e\u003ctr\u003e\u003ctd colspan=\"2\"\u003eVTE: Venous Thromboembolism, PAD: Peripheral Arterial Disease.\u003c/td\u003e\u003c/tr\u003e\u003c/tfoot\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab4\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 4\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003eSafety outcomes post-acute kidney injury in elderly patients.\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"2\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u003cp\u003eCharacteristic\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u003cp\u003eTotal\u003c/p\u003e\u003cp\u003e(N\u0026thinsp;=\u0026thinsp;97)\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eDialysis after AKI, n (%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eYes\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e20 (20.62)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eNo\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e77 (79.38)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eDeath within hospitalization, n (%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eYes\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e19 (19.59)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eNo\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e78 (80.41)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eDays to death (days), median (IQR)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e9 (12\u0026thinsp;\u0026minus;\u0026thinsp;1)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003ctfoot\u003e\u003ctr\u003e\u003ctd colspan=\"2\"\u003eAKI: Acute Kidney Injury, IQR: Interquartile range.\u003c/td\u003e\u003c/tr\u003e\u003c/tfoot\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab5\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 5\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003eFactors associated with need of dialysis.\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"4\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003eFactor\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e\u003cp\u003eNeed of dialysis\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c4\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e\u003cem\u003ep\u003c/em\u003e-value\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u003cp\u003eNo\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003eYes\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eAge (mean, standard deviation)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e73.73\u0026thinsp;\u003cspan type=\"Underline\" class=\"Underline\" name=\"Emphasis\"\u003e\u0026plusmn;\u003c/span\u003e\u0026thinsp;10.46\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e71.8\u0026thinsp;\u003cspan type=\"Underline\" class=\"Underline\" name=\"Emphasis\"\u003e\u0026plusmn;\u003c/span\u003e\u0026thinsp;9.29\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e0.455\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eGender\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\" morerows=\"2\" rowspan=\"3\"\u003e\u003cp\u003e0.121\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eMale\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e38 (86.4%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e6 (13.6%)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eFemale\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e39 (73.6%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e14 (26.4%)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eBMI category\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\" morerows=\"3\" rowspan=\"4\"\u003e\u003cp\u003e0.455\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eNormal weight\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e27 (87.1%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e4 (12.9%)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eOverweight\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e21 (75%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e7 (25%)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eObese\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e27 (77.1%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e8 (22.9%)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eSmoking\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\" morerows=\"2\" rowspan=\"3\"\u003e\u003cp\u003e0.427\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eNo\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e73 (80.2%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e18 (19.8%)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eYes\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e4 (66.7%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e2 (33.3%)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eAnaemia\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\" morerows=\"2\" rowspan=\"3\"\u003e\u003cp\u003e0.086\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eNo\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e22 (91.7%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e2 (8.3%)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eYes\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e55 (75.3%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e18 (24.7%)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eHeart failure\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\" morerows=\"2\" rowspan=\"3\"\u003e\u003cp\u003e0.181\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eNo\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e54 (76.1%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e17 (23.9%)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eYes\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e23 (88.5%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e3 (11.5%)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eDyslipidemia\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\" morerows=\"2\" rowspan=\"3\"\u003e\u003cp\u003e0.188\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eNo\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e64 (82.1%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e14 (17.9%)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eYes\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e13 (68.4%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e6 (31.6%)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eAtrial fibrillation\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\" morerows=\"2\" rowspan=\"3\"\u003e\u003cp\u003e0.689\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eNo\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e68 (80%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e17 (20%)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eYes\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e9 (75%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e3 (25%)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003ePulmonary hypertension\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\" morerows=\"2\" rowspan=\"3\"\u003e\u003cp\u003e0.242\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eNo\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e72 (78.3%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e20 (21.7%)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eYes\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e5 (100%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0 (0%)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eHypertension\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\" morerows=\"2\" rowspan=\"3\"\u003e\u003cp\u003e0.958\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eNo\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e15 (78.9%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e4 (21.1%)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eYes\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e62 (79.5%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e16 (26.5%)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eDiabetes mellitus\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\" morerows=\"2\" rowspan=\"3\"\u003e\u003cp\u003e0.576\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eNo\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e22 (75.9%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e7 (24.1%)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eYes\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e55 (80.9%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e13 (19.1%)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eAcute kidney injury (AKI) reason\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\" morerows=\"4\" rowspan=\"5\"\u003e\u003cp\u003e0.459\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eInfection\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e17 (70.8%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e7 (29.2%)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eHypovolemia\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e12 (92.3%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e1 (7.7%)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eMedication\u003csup\u003ea\u003c/sup\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e15 (83.3%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e3 (16.7%)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eComorbidity\u003csup\u003eb\u003c/sup\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e22 (78.6%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e6 (21.4%)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003ctfoot\u003e\u003ctr\u003e\u003ctd colspan=\"4\"\u003e*Significant at level 0.05\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd colspan=\"4\"\u003e\u003csup\u003ea\u003c/sup\u003e Frusemide, Nonsteroidal anti-inflammatory drugs, Angiotensin-converting enzyme inhibitor, and Angiotensin receptor blocker.\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd colspan=\"4\"\u003e\u003csup\u003eb\u003c/sup\u003e Age, Gender, Body mass index, Smoking, Anemia, Heart failure, Dyslipidemia, Atrial fibrillation, Pulmonary hypertension, Hypertension, and Diabetes mellitus\u003c/td\u003e\u003c/tr\u003e\u003c/tfoot\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab6\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 6\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003eFactors associated with number of deaths\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"4\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003eFactor\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e\u003cp\u003eDeath\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c4\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e\u003cem\u003ep\u003c/em\u003e-value\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u003cp\u003eNo\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003eYes\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eAge (mean, standard deviation\u003cb\u003e)\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e72.51\u0026thinsp;\u003cspan type=\"Underline\" class=\"Underline\" name=\"Emphasis\"\u003e\u0026plusmn;\u003c/span\u003e\u0026thinsp;10.06\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e76.68\u0026thinsp;\u003cspan type=\"Underline\" class=\"Underline\" name=\"Emphasis\"\u003e\u0026plusmn;\u003c/span\u003e\u0026thinsp;10.44\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e0.111\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eGender\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\" morerows=\"2\" rowspan=\"3\"\u003e\u003cp\u003e0.751\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eMale\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e36 (81.8%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e8 (18.2%)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eFemale\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e42 (79.2%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e11 (20.8%)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eBMI category\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\" morerows=\"3\" rowspan=\"4\"\u003e\u003cp\u003e0.746\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eNormal weight\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e25 (80.6%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e6 (19.4%)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eOverweight\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e22 (78.6%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e6 (21.4%)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eObese\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e30 (85.7%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e5 (14.3%)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eSmoking\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\" morerows=\"2\" rowspan=\"3\"\u003e\u003cp\u003e0.852\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eNo\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e73 (80.2%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e18 (19.8%)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eYes\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e5 (83.3%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e1 (15.7%)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eAnaemia\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\" morerows=\"2\" rowspan=\"3\"\u003e\u003cp\u003e0.109\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eNo\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e22 (91.7%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e2 (8.3%)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eYes\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e56 (76.7%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e17 (23.3%)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eDyslipidaemia\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\" morerows=\"2\" rowspan=\"3\"\u003e\u003cp\u003e0.642\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eNo\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e62 (79.5%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e16 (20.5%)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eYes\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e16 (84.2%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e3 (15.8%)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eAtrial fibrillation\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\" morerows=\"2\" rowspan=\"3\"\u003e\u003cp\u003e0.785\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eNo\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e68 (80%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e17 (20%)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eYes\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e10 (83.3%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e2 (16.7%)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003ePulmonary hypertension\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\" morerows=\"2\" rowspan=\"3\"\u003e\u003cp\u003e0.257\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eNo\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e73 (79.3%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e19 (20.7%)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eYes\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e5 (100%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0 (0%)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eHypertension\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\" morerows=\"2\" rowspan=\"3\"\u003e\u003cp\u003e0.410\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eNo\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e14 (73.7%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e5 (26.3%)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eYes\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e64 (82.1%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e14 (17.9%)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eDiabetes mellitus\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\" morerows=\"2\" rowspan=\"3\"\u003e\u003cp\u003e0.348\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eNo\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e25 (86.2%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e4 (13.8%)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eYes\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e53 (77.9%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e15 (22.1%)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eAcute kidney injury (AKI) cause\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\" morerows=\"4\" rowspan=\"5\"\u003e\u003cp\u003e0.001*\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eInfection\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e13 (54.2%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e11 (45.8%)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eHypovolemia\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e12 (92.3%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e1 (7.7%)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eMedication\u003csup\u003ea\u003c/sup\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e15 (83.3%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e3 (16.7%)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eComorbidity\u003csup\u003eb\u003c/sup\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e27 (96.4%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e1 (3.6%)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eFurosemide\u003c/p\u003e\u003cp\u003eNo\u003c/p\u003e\u003cp\u003eYes\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e46 (74%)\u003c/p\u003e\u003cp\u003e32 (91%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e16 (26%)\u003c/p\u003e\u003cp\u003e3 (9%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e0.040*\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eAspirin\u003c/p\u003e\u003cp\u003eNo\u003c/p\u003e\u003cp\u003eYes\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e51 (80%)\u003c/p\u003e\u003cp\u003e27 (81%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e13 (20%)\u003c/p\u003e\u003cp\u003e6 (19%)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e0.802\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003ctfoot\u003e\u003ctr\u003e\u003ctd colspan=\"4\"\u003e*Significant at level 0.05\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd colspan=\"4\"\u003e\u003csup\u003ea\u003c/sup\u003e Frusemide, Nonsteroidal anti-inflammatory drugs, Angiotensin-converting enzyme inhibitor, and Angiotensin receptor blocker.\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd colspan=\"4\"\u003e\u003csup\u003eb\u003c/sup\u003e Age, Gender, Body mass index, Smoking, Anemia, Heart failure, Dyslipidemia, Atrial fibrillation, Pulmonary hypertension, Hypertension, and Diabetes mellitus.\u003c/td\u003e\u003c/tr\u003e\u003c/tfoot\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e"},{"header":"4. Discussion","content":"\u003cp\u003eControlling risk factors for AKI is essential for preventing its occurrence, progression, and associated complications. Identifying patients at high risk for AKI has become a primary focus of numerous predictive models. However, the effectiveness and accuracy of these models tend to diminish with increasing patient age (Kate et al., \u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e2016\u003c/span\u003e). Therefore, focusing on reducing risk factors is more effective approach than relying on early prediction of AKI in older adults.\u003c/p\u003e\u003cp\u003eIn this study, hypertension, anemia, diabetes mellitus, hypocalcemia, and chronic kidney disease were found to be the most frequent risk factors among elderly patients. There is a scarcity of studies focusing on AKI risk factors in the elderly. Harbrecht (2019) explored the risk factors and outcomes of AKI in elderly patients who experienced trauma. They found that male gender, hypotension, and injury in the extremity are the risk factors associated with AKI development. In contrast, hypertension and diabetes did not show association with AKI in the elderly trauma patients (Harbrecht et al., \u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e2019\u003c/span\u003e). Another study by Jain (2017) identified risk factors for AKI in elderly patients with diabetes and community acquired pneumonia. Their findings indicated that male sex, hypertension, the use of ACE inhibitors (ACEIs) and angiotensin II receptor blockers (ARBs), as well as insulin therapy, were independently associated with an increased risk of AKI in this patient population (Jain et al., \u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e2017\u003c/span\u003e).\u003c/p\u003e\u003cp\u003eIn our study however, presence of comorbidities was the most prevalent risk factor in the Saudi population. Consistent with our findings, other studies have reported that comorbidities like diabetes mellitus, hypertension, pre-existing CKD, and elevated bassline SCr levels are significantly associated to the development of AKI (Alhamad et al., \u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e2023\u003c/span\u003e; Alkhunaizi et al., \u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2011\u003c/span\u003e; Farooqui et al., \u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e2021\u003c/span\u003e). When stratifying patients based on the setting of AKI causes, comorbidities remained the leading risk factor in community-acquired cases. In contrast, among hospitalized patients, medications were the most common contributing factor.\u003c/p\u003e\u003cp\u003eThe challenging of AKI lies in its association with a high mortality rate, as previously reported (Farooqui et al., \u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e2021\u003c/span\u003e; Hoste et al., \u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e2015\u003c/span\u003e; Sousa et al., \u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e2020\u003c/span\u003e). In our study, nearly one-fifth of the patients who developed AKI died during their hospitalization. In Sousa\u0026rsquo;s (2020) study of patients over 90 years old, the overall in-hospital mortality was significantly greater in those with AKI compared to those without AKI (66.8% vs. 23.8%), \u003cem\u003ep\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.001 (Sousa et al., \u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e2020\u003c/span\u003e). Similarly, elderly Saudi patients had a significantly higher 30-day mortality rate of 40.7% in who developed AKI compared to only 3.7% in those without AKI (Farooqui et al., \u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e2021\u003c/span\u003e). Moreover, Hoste (2015) found that increasing severity of AKI was linked to significantly higher adjusted odds of hospital mortality by approximately three times greater in Stage 2 and nearly seven times greater in Stage 3 compared to patients without AKI or with less severe disease (Hoste et al., \u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e2015\u003c/span\u003e).\u003c/p\u003e\u003cp\u003eIn our study, we found a significant association between the cause of AKI and overall mortality. The highest mortality rate (45.8%) occurred in patients with infection-related AKI, which consistent with previous findings (Pan et al., \u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e2016\u003c/span\u003e; Silver et al., \u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e2018\u003c/span\u003e; Vandijck et al., \u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e2007\u003c/span\u003e). Additionally, we found that the use of furosemide was statistically associated with lower mortality compared to non-use (\u003cem\u003ep\u003c/em\u003e-value\u0026thinsp;=\u0026thinsp;0.04). Our results align with a study by Zhao (2020), which demonstrated that furosemide use in critically ill patients with AKI was associated with enhanced short-term survival and improved renal function recovery (Zhao et al., \u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e2020\u003c/span\u003e). However, a systematic review and meta-analysis by Krzych and Czempik (\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e2019\u003c/span\u003e) did not find a consistent mortality benefit from furosemide use, except in cases of contrast-induced AKI (Krzych \u0026amp; Czempik, \u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e2019\u003c/span\u003e).\u003c/p\u003e\u003cp\u003eProgression to end-stage renal disease (ESRD), requiring renal replacement therapy, is another significant consequence of AKI. In our sample, one in five patients required renal replacement therapy. Similarly, Ishani (2009) found that among elderly patients with AKI, the probability of initiating dialysis for ESRD within 30 days was 0.96%, compared to 0.04% in patients without AKI, with the risk increasing steadily after discharge (Ishani et al., \u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e2009\u003c/span\u003e). In contrast, Hsu (2007) studied the incidence of AKI in the community in Northern California, found that elderly patients who aged 80 years or above are less likely to receive renal replacement therapy despite being more likely to have AKI. They hypothesized that this could be due to the lower likelihood of dialysis being prescribed for elderly patients and greater reluctance among this group to undergo such treatment (Hsu et al., \u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e2007\u003c/span\u003e). Moreover, hospitalized patients with AKI who required renal replacement therapy experienced significantly higher mortality rates than those who did not undergo such treatment (Alhamad et al., \u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e2023\u003c/span\u003e; Alkhunaizi et al., \u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2011\u003c/span\u003e; Farooqui et al., \u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e2021\u003c/span\u003e).\u003c/p\u003e\u003cp\u003eThis study has certain limitations. First, the study was conducted at a single medical center (KSUMC in Riyadh), which may limit the generalizability of the findings to other hospitals or regions, especially rural or under-resourced settings. Second, the small sample size reduced the statistical power of the analysis, leading some results to fall short of significance. For example, no significant association was found between the need for dialysis and any of the examined risk factors, likely due to the limited number of patients requiring replacement therapy. Third, the current study highlights acute renal failure in Saudi elderly and the risk factors prevalent among this group in particular. Therefore, future studies should focus on factors influencing older adults who develop AKI along with a group of healthy older adults. Fourth, the analysis have not controlled for all confounding factors such as fluid balance, infection severity, medication dosages, medication timing, and drug combinations. Fifth, due to its retrospective design, the study was subject to incomplete or missing data from electronic medical records.\u003c/p\u003e"},{"header":"5. Conclusion","content":"\u003cp\u003eThis study highlights the burden of AKI among elderly patients in Saudi Arabia, revealing that common comorbidities such as hypertension, anemia, diabetes mellitus, and chronic kidney disease significantly contribute to AKI development in this population. The findings also indicate a notable association between infection-related AKI and higher mortality rates, while the use of furosemide was associated with improved survival outcomes. Despite these insights, the study's limitations including its retrospective design, small sample size, lack of a healthy control group, and single center setting warrant cautious interpretation of the results. Future research should include larger, multicenter prospective studies with comparative groups to better identify modifiable risk factors and develop effective preventive and management strategies tailored to the elderly.\u003c/p\u003e"},{"header":"Abbreviations","content":"\u003cp\u003eAKI: Acute kidney injury.\u003c/p\u003e\n\u003cp\u003eKDIGO: The Kidney Disease Improving Global Outcomes guidelines.\u003c/p\u003e\n\u003cp\u003eSCr: Serum Creatinine.\u003c/p\u003e\n\u003cp\u003eICU: Intensive Care Unit.\u003c/p\u003e\n\u003cp\u003eWHO: World Health Organization.\u003c/p\u003e\n\u003cp\u003eCrcl: Creatinine clearance.\u003c/p\u003e\n\u003cp\u003eESRD: End-stage renal disease.\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eSupplementary Materials:\u0026nbsp;\u003c/strong\u003eThe following supporting information can be downloaded at: www.xxx.com/xxx, (Online Resource 1): Percentage of risk factors for acute kidney injury in elderly patients; (Online Resource 2): Reason categories of acute kidney injury in the elderly.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthor Contributions:\u003c/strong\u003e Conceptualization, A.Sh and A.A.; methodology, N.A.; software, N.A; validation, A.A., \u0026nbsp;A.Sh; formal analysis, A.Sh and N.A.; investigation, A.Sh; resources, A.Sh ; data curation, A.Sh; writing—original draft preparation, All Authors; writing—review and editing, All Authors; visualization, All Authors; supervision, A.A.; project administration, N.A.; funding acquisition, A.Sh All authors have read and agreed to the published version of the manuscript.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding:\u003c/strong\u003e This research received no external funding.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eInstitutional Review Board Statement:\u0026nbsp;\u003c/strong\u003eThe study was conducted in accordance with the Declaration of Helsinki, and approved by the Institutional Review Board (or Ethics Committee) of King Saud University (protocol code 20/031/IRB on 22 January 2020).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eInformed Consent Statement:\u0026nbsp;\u003c/strong\u003eNot applicable.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAcknowledgments:\u003c/strong\u003e\u0026nbsp; The authors thank the Deanship of Scientific Research and RSSU at King Saud University for their technical support. Additionally, we would like to extend our appreciation to the Deanship of Scientific Research at King Saud University for their logistical support of this study through the Research Assistant Internship Program. The authors acknowledge SCIBENDI for English editing.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAvailability of data and materials:\u003c/strong\u003e Data is available on request due to privacy/ethical restrictions. The data that support the findings of this study are available on request from the corresponding author, [AFA]. The data are not publicly available due to containing information that could compromise the privacy of research participants.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConflicts of Interest:\u003c/strong\u003e The authors declare no conflict of interest.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n\u003cli\u003eAlhamad, F. S., Almohaimeed, Y. S., Alhayzan, M. H., Alturaymi, M. A., Almutairi, K. Z., Almuhanna, A., Alminhali, S., \u0026amp; Elhassan, E. (2023, Aug). Prevalence and Risk Factors Associated With Acute Kidney Injury After Transcatheter Aortic Valve Replacement at a Tertiary Hospital in Riyadh, Saudi Arabia. \u003cem\u003eCureus, 15\u003c/em\u003e(8), e43381. https://doi.org/10.7759/cureus.43381\u003c/li\u003e\n\u003cli\u003eAlkhunaizi, A. M., Shah, S. S., Wesslen, U. S., Al Sadah, Z. A., \u0026amp; Antony, A. (2011, Jun). Acute kidney injury after cardiac surgery in eastern Saudi Arabia. \u003cem\u003eEast Mediterr Health J, 17\u003c/em\u003e(6), 495-500.\u003c/li\u003e\n\u003cli\u003eFarooqui, M. A., Almegren, A., Binrushud, S. R., Alnuwaiser, F. A., Almegren, N. M., Alhamied, N. A., Aloraifi, E. A., Alothman, A. M., Aldafas, M. A., Ardah, H. I., \u0026amp; Alhejaili, F. F. (2021, Oct). Incidence and Outcome of Acute Kidney Injury in Patients Hospitalized With Coronavirus Disease-19 at a Tertiary Care Medical Center in Saudi Arabia. \u003cem\u003eCureus, 13\u003c/em\u003e(10), e18927. https://doi.org/10.7759/cureus.18927 \u003c/li\u003e\n\u003cli\u003eHarbrecht, B. G., Broughton-Miller, K., Frisbie, M., Wojcik, J., Pentecost, K., Doan, R., Nash, N. A., \u0026amp; Miller, K. R. (2019). Risk factors and outcome of acute kidney injury in elderly trauma patients. \u003cem\u003eThe American Journal of Surgery, 218\u003c/em\u003e(3), 480-483.\u003c/li\u003e\n\u003cli\u003eHimmelfarb, J. (2009). Acute kidney injury in the elderly: problems and prospects. Seminars in nephrology,\u003c/li\u003e\n\u003cli\u003eHoste, E. A., Bagshaw, S. M., Bellomo, R., Cely, C. M., Colman, R., Cruz, D. N., Edipidis, K., Forni, L. G., Gomersall, C. D., Govil, D., Honor\u0026eacute;, P. M., Joannes-Boyau, O., Joannidis, M., Korhonen, A. M., Lavrentieva, A., Mehta, R. L., Palevsky, P., Roessler, E., Ronco, C., Uchino, S., Vazquez, J. A., Vidal Andrade, E., Webb, S., \u0026amp; Kellum, J. A. (2015, Aug). Epidemiology of acute kidney injury in critically ill patients: the multinational AKI-EPI study. \u003cem\u003eIntensive Care Med, 41\u003c/em\u003e(8), 1411-1423. https://doi.org/10.1007/s00134-015-3934-7\u003c/li\u003e\n\u003cli\u003eHsu, C.-Y., McCulloch, C., Fan, D., Ordonez, J., Chertow, G., \u0026amp; Go, A. (2007). Community-based incidence of acute renal failure. \u003cem\u003eKidney international, 72\u003c/em\u003e(2), 208-212.\u003c/li\u003e\n\u003cli\u003eIshani, A., Xue, J. L., Himmelfarb, J., Eggers, P. W., Kimmel, P. L., Molitoris, B. A., \u0026amp; Collins, A. J. (2009). Acute kidney injury increases risk of ESRD among elderly. \u003cem\u003eJournal of the American Society of Nephrology: JASN, 20\u003c/em\u003e(1), 223.\u003c/li\u003e\n\u003cli\u003eJain, A., McDonald, H. I., Nitsch, D., Tomlinson, L., \u0026amp; Thomas, S. L. (2017). Risk factors for developing acute kidney injury in older people with diabetes and community-acquired pneumonia: a population-based UK cohort study. \u003cem\u003eBMC nephrology, 18\u003c/em\u003e, 1-16.\u003c/li\u003e\n\u003cli\u003eJeannotte, L., \u0026amp; Moore, M. J. (2007). The state of aging and health in America 2007.\u003c/li\u003e\n\u003cli\u003eKane-Gill, S. L., Sileanu, F. E., Murugan, R., Trietley, G. S., Handler, S. M., \u0026amp; Kellum, J. A. (2015). Risk factors for acute kidney injury in older adults with critical illness: a retrospective cohort study. \u003cem\u003eAmerican journal of kidney diseases, 65\u003c/em\u003e(6), 860-869.\u003c/li\u003e\n\u003cli\u003eKate, R. J., Perez, R. M., Mazumdar, D., Pasupathy, K. S., \u0026amp; Nilakantan, V. (2016, Mar 29). Prediction and detection models for acute kidney injury in hospitalized older adults. \u003cem\u003eBMC Med Inform Decis Mak, 16\u003c/em\u003e, 39. https://doi.org/10.1186/s12911-016-0277-4\u003c/li\u003e\n\u003cli\u003eKhwaja, A. (2012). KDIGO clinical practice guidelines for acute kidney injury. \u003cem\u003eNephron Clinical Practice, 120\u003c/em\u003e(4), c179-c184.\u003c/li\u003e\n\u003cli\u003eKrzych, Ł. J., \u0026amp; Czempik, P. F. (2019). Impact of furosemide on mortality and the requirement for renal replacement therapy in acute kidney injury: a systematic review and meta-analysis of randomised trials. \u003cem\u003eAnnals of Intensive Care, 9\u003c/em\u003e, 1-9.\u003c/li\u003e\n\u003cli\u003ePan, H., Wu, P., Wu, V., Yang, Y., Huang, T., Shiao, C., Chen, T., Tarng, D., Lin, J., \u0026amp; Yang, W. (2016). Taiwan Consortium for Acute Kidney Injury and Renal Diseases (CAKs): A nationwide survey of clinical characteristics, management, and outcomes of acute kidney injury (AKI)\u0026mdash;patients with and without preexisting chronic kidney disease have different prognoses. \u003cem\u003eMedicine (Baltimore), 95\u003c/em\u003e(39), e4987.\u003c/li\u003e\n\u003cli\u003eSilver, S. A., Harel, Z., McArthur, E., Nash, D. M., Acedillo, R., Kitchlu, A., Garg, A. X., Chertow, G. M., Bell, C. M., \u0026amp; Wald, R. (2018). Causes of death after a hospitalization with AKI. \u003cem\u003eJournal of the American Society of Nephrology: JASN, 29\u003c/em\u003e(3), 1001.\u003c/li\u003e\n\u003cli\u003eSousa, A. L. B., de Souza, L. M., Santana Filho, O. V., e L\u0026eacute;da, V. H. F., \u0026amp; Rocha, P. N. (2020, 2020/01/30). Incidence, predictors and prognosis of acute kidney injury in nonagenarians: an in-hospital cohort study. \u003cem\u003eBMC nephrology, 21\u003c/em\u003e(1), 34. https://doi.org/10.1186/s12882-020-1698-y\u003c/li\u003e\n\u003cli\u003eVandijck, D., Reynvoet, E., Blot, S., Vandecasteele, E., \u0026amp; Hoste, E. (2007). Severe infection, sepsis and acute kidney injury. \u003cem\u003eActa Clinica Belgica, 62\u003c/em\u003e(sup2), 332-336.\u003c/li\u003e\n\u003cli\u003eXu, L., Wu, Y., Chen, Y., Li, R., Wang, Z., Li, Z., Liu, G., Yu, L., Shi, W., \u0026amp; Liang, X. (2021, Jan 6). Is acute kidney injury age-dependent in older adults: an observational study in two centers from North China. \u003cem\u003eBMC Geriatr, 21\u003c/em\u003e(1), 7. https://doi.org/10.1186/s12877-020-01906-z\u003c/li\u003e\n\u003cli\u003eZhao, G.-j., Xu, C., Ying, J.-c., L\u0026uuml;, W.-b., Hong, G.-l., Li, M.-f., Wu, B., Yao, Y.-m., \u0026amp; Lu, Z.-q. (2020). Association between furosemide administration and outcomes in critically ill patients with acute kidney injury. \u003cem\u003eCritical care, 24\u003c/em\u003e, 1-9. \u003c/li\u003e\n\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":true,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"journal-of-umm-alqura-university-for-medical-science","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"","sideBox":"Learn more about [Journal of Umm Al-Qura University for Medical Science](https://link.springer.com/journal/44361)","snPcode":"44361","submissionUrl":"https://submission.springernature.com/new-submission/44361/3","title":"Journal of Umm Al-Qura University for Medical Science","twitterHandle":"","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"stoa","reportingPortfolio":"Springer Open","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"Acute, Elderly, Failure, Injury, Kidney, Renal.","lastPublishedDoi":"10.21203/rs.3.rs-7093452/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-7093452/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003e\u003cstrong\u003eIntroduction:\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eControlling risk factors for acute kidney failure (AKI) in the elderly is crucial for preventing its occurrence, progression, and complications. Therefore, this study aims to identify risk factors that may increase the likelihood of AKI in elderly patients in Saudi Arabia.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eMethod:\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eA retrospective observational study was conducted involving elderly patients aged 65 years and older who were hospitalized with a diagnosis of acute kidney injury (AKI). The diagnosis of AKI was identified according to the KDIGO guidelines (Kidney Disease Improving Global Outcomes). Patient demographics were analysed to identify potential risk factors associated with AKI. The study also assessed the proportion of AKI causes, the number of patients requiring renal replacement therapy, and the associated mortality rate.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eResults:\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe study included a total of 97 patients. The most common risk factors were hypertension (n = 78, 80.41%), anemia (n = 73, 75.26%), diabetes mellitus (n = 68, 70.10%), hypocalcemia (n = 34, 35.05%), chronic kidney disease (n = 32, 32.99%), ischemic heart disease (n = 27, 27.84%), heart failure (n = 26, 26.80%), cerebrovascular events (n = 14, 14.43%), cancer (n = 13, 13.40%), and atrial fibrillation (n = 12, 12.37%). The most frequent causes of AKI, regardless of whether it developed in the hospital or the community, were comorbidities (29%), infections (25%), and medications (19%). Among hospitalized patients, medications (40%) were the most common cause, while among community-acquired cases, comorbidities (44%) were predominant. A small proportion of patients required dialysis following AKI (n = 20). Death occurred in 19 patients, with a median duration of nine days (IQR: 1–12) from AKI onset to death. The cause of AKI was significantly associated with overall mortality (\u003cem\u003ep\u003c/em\u003e = 0.001), with the highest mortality observed in patients whose AKI was infection-related (45.8%). Additionally, the use of furosemide was statistically associated with a lower mortality rate compared to those who did not receive it (\u003cem\u003ep\u003c/em\u003e = 0.04).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConclusion:\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eAKI in elderly patients in Saudi Arabia is a significant clinical problem, with comorbidities like hypertension, anemia, and diabetes being key risk factors. Infection-related AKI is linked to higher mortality, while furosemide use may improve outcomes. Further large scale studies are needed to confirm these findings and guide prevention strategies.\u003c/p\u003e","manuscriptTitle":"Acute Kidney Injury in Elderly Patients in Saudi Arabia: Retrospective Study","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-08-25 16:25:07","doi":"10.21203/rs.3.rs-7093452/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"decision","content":"Revision requested","date":"2025-10-04T08:35:23+00:00","index":"","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2025-10-03T23:48:38+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2025-10-02T13:53:00+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"68925998340107024243053631150954993535","date":"2025-09-20T00:22:59+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"316103081432650180563540797873296052378","date":"2025-09-19T14:31:54+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"204194343444147272470624613882579703273","date":"2025-09-19T12:00:33+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2025-09-06T11:38:12+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"90557981842747400604176133978829661548","date":"2025-08-20T07:03:05+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"288823183799134568900796657114375683968","date":"2025-08-18T05:42:06+00:00","index":"hide","fulltext":""},{"type":"reviewersInvited","content":"","date":"2025-08-18T04:25:07+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2025-08-11T12:36:12+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2025-08-11T04:19:24+00:00","index":"","fulltext":""},{"type":"submitted","content":"Journal of Umm Al-Qura University for Medical Science","date":"2025-08-08T18:45:13+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"journal-of-umm-alqura-university-for-medical-science","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"","sideBox":"Learn more about [Journal of Umm Al-Qura University for Medical Science](https://link.springer.com/journal/44361)","snPcode":"44361","submissionUrl":"https://submission.springernature.com/new-submission/44361/3","title":"Journal of Umm Al-Qura University for Medical Science","twitterHandle":"","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"stoa","reportingPortfolio":"Springer Open","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"2128a3f3-2c68-4add-8570-5d8cf4ce6edb","owner":[],"postedDate":"August 25th, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"under-review","subjectAreas":[],"tags":[],"updatedAt":"2025-11-22T11:53:09+00:00","versionOfRecord":[],"versionCreatedAt":"2025-08-25 16:25:07","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-7093452","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-7093452","identity":"rs-7093452","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}