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Geriatric patients with acute kidney injury in the intensive care unit: the effect of vitamin B12 and albumin levels on survival

Year 2024, EARLY ONLINE, 1 - 8
https://doi.org/10.18621/eurj.1495394

Abstract

Objectives: Acute kidney injury (AKI) is a common and critically important clinical entity in geriatric age group. In addition, higher mortality rates are seen in cases requiring intensive care treatment. We have aimed to investigate the effect of vitamin B12 and albumin levels on mortality in critically ill geriatric patients with AKI.

Methods: Geriatric patients hospitalised in the Intensive Care Unit with a diagnosis of AKI between 07.01.2014-07.01.2015 were retrospectively screened and included in the study. Two groups were formed from discharged and exited patients. General characteristics and laboratory values of the patients were scanned from the hospital archives and recorded. Statistically significant intergroup differences in terms of demographic characteristics, and biochemical values were determined by statistical analysis.

Results: A total of 103 patients, including 53 females were enrolled in the study, while 72.2% of the patients had prerenal AKI. The mortality rate was 47.57% in all patients. There was no difference between groups in terms of mortality rates, etiologic factors and KDIGO staging. Vitamin B12 was high and albümin was low the group who succumbed to death. In addition, mortality rates increased by 10% for every 100 units increase in vitamin B12 value and decreased by 22% for every 10 units increase in albumin value.

Conclusions: We have determined that an increase in albumin levels during clinical follow-up decreased mortality rates and an increase in vitamin B12 levels directly increased mortality rates. Hypoalbuminemia and high vitamin B12 levels were found to be independent predictive factors for mortality in AKI.

Ethical Statement

Ethical approval was received from the ethics committee of Kütahya Health Sciences University Faculty of Medicine with the decision dated 24.02.2021 and numbered 2021/03-15.

References

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  • 2. Lameire N, Nelde A, Hoeben H, Vanholder R. Acute renal failure in the elderly. Geriatr Nephrol Urol. 1999;9(3):153-165. doi: 10.1023/a:1008322515136.
  • 3. Pascual J, Orofino L, Liano F, et al. Incidence and prognosis of acute renal failure in older patients. J Am Geriatr Soc. 1990;38(1):25-30. doi: 10.1111/j.1532-5415.1990.tb01592.x.
  • 4. Molitoris B. Acute Kidney Injury. In: Goldman L, Schafer AI, editors. Goldman-Cecil Medicine. 26th ed. Philadelphia: Elsevier; 2020: p. 748-753.
  • 5. KDIGO AKI Work Group. KDIGO clinical practice guideline for acute kidney injury. Kidney Int Suppl. 2012;2(1):1-138.
  • 6. Lou LM, Boned B, Gimeno JA, et al. [Characteristics of acute renal failure in elderly patients admitted to a small town hospital]. Nefrologia. 2002;22(6):547-554. [Article in Spanish]
  • 7. Peters T. Albumin. San Diego: Academic Press; 1995.
  • 8. Dubois MJ, Orellana-Jimenez C, Melot C, et al. Albumin administration improves organ function in critically ill hypoalbuminemic patients: A prospective, randomized, controlled, pilot study. Crit Care Med. 2006;34(10):2536-2540. doi: 10.1097/01.CCM.0000239119.57544.0C.
  • 9. Stabler SP. Clinical practice. Vitamin B12 deficiency. N Engl J Med. 2013;368(2):149-160. doi: 10.1056/NEJMcp1113996.
  • 10. Capelli I, Cianciolo G, Gasperoni L, et al. Folic Acid and Vitamin B12 Administration in CKD, Why Not? Nutrients. 2019;11(2):383. doi: 10.3390/nu11020383.
  • 11. Carmel R, Vasireddy H, Aurangzeb I, George K. High serum cobalamin levels in the clinical setting--clinical associations and holo-transcobalamin changes. Clin Lab Haematol. 2001;23(6):365-371. doi: 10.1046/j.1365-2257.2001.00134.x.
  • 12. Geissbühler P, Mermillod B, Rapin CH. Elevated serum vitamin B12 levels associated with CRP as a predictive factor of mortality in palliative care cancer patients: a prospective study over five years. J Pain Symptom Manage. 2000;20(2):93-103. doi: 10.1016/s0885-3924(00)00169-x.
  • 13. Beck LH. Changes in renal function with aging. Clin Geriatr Med. 1998;14(2):199-209.
  • 14. Hoang K, Tan JC, Derby G, et al. Determinants of glomerular hypofiltration in aging humans. Kidney Int. 2003 Oct;64(4):1417-1424. doi: 10.1046/j.1523-1755.2003.00207.x.
  • 15. Johnson TM 2nd, Miller M, Pillion DJ, Ouslander JG. Arginine vasopressin and nocturnal polyuria in older adults with frequent nighttime voiding. J Urol. 2003;170(2 Pt 1):480-484. doi: 10.1097/01.ju.0000071406.18453.5f.
  • 16. Liaño F, Pascual J. Epidemiology of acute renal failure: a prospective, multicenter, community-based study. Madrid Acute Renal Failure Study Group. Kidney Int. 1996;50(3):811-818. doi: 10.1038/ki.1996.380.
  • 17. Pascual J, Liaño F. Causes and prognosis of acute renal failure in the very old. Madrid Acute Renal Failure Study Group. J Am Geriatr Soc. 1998;46(6):721-725. doi: 10.1111/j.1532-5415.1998.tb03807.x.
  • 18. Bagshaw SM, Uchino S, Bellomo R, et al; Beginning and Ending Supportive Therapy for the Kidney (BEST Kidney) Investigators. Septic acute kidney injury in critically ill patients: clinical characteristics and outcomes. Clin J Am Soc Nephrol. 2007;2(3):431-439. doi: 10.2215/CJN.03681106.
  • 19. Hoste EA, Lameire NH, Vanholder RC, Benoit DD, Decruyenaere JM, Colardyn FA. Acute renal failure in patients with sepsis in a surgical ICU: predictive factors, incidence, comorbidity, and outcome. J Am Soc Nephrol. 2003;14(4):1022-1030. doi: 10.1097/01.asn.0000059863.48590.e9.
  • 20. Mehta RL, Bouchard J, Soroko SB, et al; Program to Improve Care in Acute Renal Disease (PICARD) Study Group. Sepsis as a cause and consequence of acute kidney injury: Program to Improve Care in Acute Renal Disease. Intensive Care Med. 2011;37(2):241-8. doi: 10.1007/s00134-010-2089-9.
  • 21. Bagshaw SM, George C, Bellomo R; ANZICS Database Management Committee. Early acute kidney injury and sepsis: a multicentre evaluation. Crit Care. 2008;12(2):R47. doi: 10.1186/cc6863.
  • 22. Vincent JL, Wilkes MM, Navickis RJ. Safety of human albumin--serious adverse events reported worldwide in 1998-2000. Br J Anaesth. 2003;91(5):625-630. doi: 10.1093/bja/aeg233.
  • 23. Wiedermann CJ, Wiedermann W, Joannidis M. Hypoalbuminemia and acute kidney injury: a meta-analysis of observational clinical studies. Intensive Care Med. 2010;36(10):1657-1665. doi: 10.1007/s00134-010-1928-z.
  • 24. Romain M, Sviri S, Linton DM, Stav I, van Heerden PV. The role of Vitamin B12 in the critically ill--a review. Anaesth Intensive Care. 2016;44(4):447-452. doi: 10.1177/0310057X1604400410.
  • 25. Corcoran TB, O'Neill MP, Webb SA, Ho KM. Inflammation, vitamin deficiencies and organ failure in critically ill patients. Anaesth Intensive Care. 2009;37(5):740-747. doi: 10.1177/0310057X0903700510.
  • 26. House AA, Eliasziw M, Cattran DC, et al. Effect of B-vitamin therapy on progression of diabetic nephropathy: a randomized controlled trial. JAMA. 2010;303(16):1603-1609. doi: 10.1001/jama.2010.490.
  • 27. Cappello S, Cereda E, Rondanelli M, et al. Elevated Plasma Vitamin B12 Concentrations Are Independent Predictors of In-Hospital Mortality in Adult Patients at Nutritional Risk. Nutrients. 2017;9(1):1. doi: 10.3390/nu9010001.
Year 2024, EARLY ONLINE, 1 - 8
https://doi.org/10.18621/eurj.1495394

Abstract

References

  • 1. Orimo H. [Reviewing the definition of elderly]. Nihon Ronen Igakkai Zasshi. 2006;43(1):27-34. doi: 10.3143/geriatrics.43.27. [Article in Japanese]
  • 2. Lameire N, Nelde A, Hoeben H, Vanholder R. Acute renal failure in the elderly. Geriatr Nephrol Urol. 1999;9(3):153-165. doi: 10.1023/a:1008322515136.
  • 3. Pascual J, Orofino L, Liano F, et al. Incidence and prognosis of acute renal failure in older patients. J Am Geriatr Soc. 1990;38(1):25-30. doi: 10.1111/j.1532-5415.1990.tb01592.x.
  • 4. Molitoris B. Acute Kidney Injury. In: Goldman L, Schafer AI, editors. Goldman-Cecil Medicine. 26th ed. Philadelphia: Elsevier; 2020: p. 748-753.
  • 5. KDIGO AKI Work Group. KDIGO clinical practice guideline for acute kidney injury. Kidney Int Suppl. 2012;2(1):1-138.
  • 6. Lou LM, Boned B, Gimeno JA, et al. [Characteristics of acute renal failure in elderly patients admitted to a small town hospital]. Nefrologia. 2002;22(6):547-554. [Article in Spanish]
  • 7. Peters T. Albumin. San Diego: Academic Press; 1995.
  • 8. Dubois MJ, Orellana-Jimenez C, Melot C, et al. Albumin administration improves organ function in critically ill hypoalbuminemic patients: A prospective, randomized, controlled, pilot study. Crit Care Med. 2006;34(10):2536-2540. doi: 10.1097/01.CCM.0000239119.57544.0C.
  • 9. Stabler SP. Clinical practice. Vitamin B12 deficiency. N Engl J Med. 2013;368(2):149-160. doi: 10.1056/NEJMcp1113996.
  • 10. Capelli I, Cianciolo G, Gasperoni L, et al. Folic Acid and Vitamin B12 Administration in CKD, Why Not? Nutrients. 2019;11(2):383. doi: 10.3390/nu11020383.
  • 11. Carmel R, Vasireddy H, Aurangzeb I, George K. High serum cobalamin levels in the clinical setting--clinical associations and holo-transcobalamin changes. Clin Lab Haematol. 2001;23(6):365-371. doi: 10.1046/j.1365-2257.2001.00134.x.
  • 12. Geissbühler P, Mermillod B, Rapin CH. Elevated serum vitamin B12 levels associated with CRP as a predictive factor of mortality in palliative care cancer patients: a prospective study over five years. J Pain Symptom Manage. 2000;20(2):93-103. doi: 10.1016/s0885-3924(00)00169-x.
  • 13. Beck LH. Changes in renal function with aging. Clin Geriatr Med. 1998;14(2):199-209.
  • 14. Hoang K, Tan JC, Derby G, et al. Determinants of glomerular hypofiltration in aging humans. Kidney Int. 2003 Oct;64(4):1417-1424. doi: 10.1046/j.1523-1755.2003.00207.x.
  • 15. Johnson TM 2nd, Miller M, Pillion DJ, Ouslander JG. Arginine vasopressin and nocturnal polyuria in older adults with frequent nighttime voiding. J Urol. 2003;170(2 Pt 1):480-484. doi: 10.1097/01.ju.0000071406.18453.5f.
  • 16. Liaño F, Pascual J. Epidemiology of acute renal failure: a prospective, multicenter, community-based study. Madrid Acute Renal Failure Study Group. Kidney Int. 1996;50(3):811-818. doi: 10.1038/ki.1996.380.
  • 17. Pascual J, Liaño F. Causes and prognosis of acute renal failure in the very old. Madrid Acute Renal Failure Study Group. J Am Geriatr Soc. 1998;46(6):721-725. doi: 10.1111/j.1532-5415.1998.tb03807.x.
  • 18. Bagshaw SM, Uchino S, Bellomo R, et al; Beginning and Ending Supportive Therapy for the Kidney (BEST Kidney) Investigators. Septic acute kidney injury in critically ill patients: clinical characteristics and outcomes. Clin J Am Soc Nephrol. 2007;2(3):431-439. doi: 10.2215/CJN.03681106.
  • 19. Hoste EA, Lameire NH, Vanholder RC, Benoit DD, Decruyenaere JM, Colardyn FA. Acute renal failure in patients with sepsis in a surgical ICU: predictive factors, incidence, comorbidity, and outcome. J Am Soc Nephrol. 2003;14(4):1022-1030. doi: 10.1097/01.asn.0000059863.48590.e9.
  • 20. Mehta RL, Bouchard J, Soroko SB, et al; Program to Improve Care in Acute Renal Disease (PICARD) Study Group. Sepsis as a cause and consequence of acute kidney injury: Program to Improve Care in Acute Renal Disease. Intensive Care Med. 2011;37(2):241-8. doi: 10.1007/s00134-010-2089-9.
  • 21. Bagshaw SM, George C, Bellomo R; ANZICS Database Management Committee. Early acute kidney injury and sepsis: a multicentre evaluation. Crit Care. 2008;12(2):R47. doi: 10.1186/cc6863.
  • 22. Vincent JL, Wilkes MM, Navickis RJ. Safety of human albumin--serious adverse events reported worldwide in 1998-2000. Br J Anaesth. 2003;91(5):625-630. doi: 10.1093/bja/aeg233.
  • 23. Wiedermann CJ, Wiedermann W, Joannidis M. Hypoalbuminemia and acute kidney injury: a meta-analysis of observational clinical studies. Intensive Care Med. 2010;36(10):1657-1665. doi: 10.1007/s00134-010-1928-z.
  • 24. Romain M, Sviri S, Linton DM, Stav I, van Heerden PV. The role of Vitamin B12 in the critically ill--a review. Anaesth Intensive Care. 2016;44(4):447-452. doi: 10.1177/0310057X1604400410.
  • 25. Corcoran TB, O'Neill MP, Webb SA, Ho KM. Inflammation, vitamin deficiencies and organ failure in critically ill patients. Anaesth Intensive Care. 2009;37(5):740-747. doi: 10.1177/0310057X0903700510.
  • 26. House AA, Eliasziw M, Cattran DC, et al. Effect of B-vitamin therapy on progression of diabetic nephropathy: a randomized controlled trial. JAMA. 2010;303(16):1603-1609. doi: 10.1001/jama.2010.490.
  • 27. Cappello S, Cereda E, Rondanelli M, et al. Elevated Plasma Vitamin B12 Concentrations Are Independent Predictors of In-Hospital Mortality in Adult Patients at Nutritional Risk. Nutrients. 2017;9(1):1. doi: 10.3390/nu9010001.
There are 27 citations in total.

Details

Primary Language English
Subjects ​Internal Diseases
Journal Section Original Articles
Authors

Sertaş Erarslan 0000-0002-6816-4154

Türkan Paşalı Kilit 0000-0003-1126-7336

Early Pub Date August 28, 2024
Publication Date
Submission Date June 3, 2024
Acceptance Date August 23, 2024
Published in Issue Year 2024 EARLY ONLINE

Cite

AMA Erarslan S, Paşalı Kilit T. Geriatric patients with acute kidney injury in the intensive care unit: the effect of vitamin B12 and albumin levels on survival. Eur Res J. Published online August 1, 2024:1-8. doi:10.18621/eurj.1495394

e-ISSN: 2149-3189 


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