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Creatinine Increase in Elderly Means Increased Renal Disease, Mortality

Urine ProblemsApr 15 08

Even small increases in serum creatinine levels during hospitalization raise the risk of end stage renal disease and mortality of elderly patients over the long term, according to a University of Alabama at Birmingham (UAB) study in the Archives of Internal Medicine.

The 10-year retrospective study, led by UAB nephrologist Britt Newsome, M.D, is the first systematic description of creatinine increase and longer-term end stage renal disease and mortality risk. Previous studies showed a relationship between reductions in kidney function during hospitalization and higher mortality rates.

“Previous studies have shown that a rise in serum creatinine level of 0.3 milligrams per deciliter or more during hospitalization is associated with higher in-hospital mortality, longer stays and higher costs,” Newsome said. “However, little was known about the long-term risks of subsequent end-stage renal disease and mortality in this population. The long-term risks we observed suggest that even the least severe category of kidney injury may indicate a worse prognosis.”

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Antipsychotic Drugs Increase Risk of Developing Pneumonia in Elderly

Respiratory ProblemsApr 15 08

Elderly patients who use antipsychotic drugs have a 60 percent increased risk of developing pneumonia compared to non-users. This risk is highest in the first week following prescription and decreases gradually thereafter. These findings are published in Journal of the American Geriatrics Society.

Antipsychotic drugs are frequently used in elderly patients for the treatment of psychosis and behavioral problems associated with dementia and delirium. This study is the first to show that the development of pneumonia is associated with antipsychotic drug use.

“The risk of developing pneumonia is not associated with long-term use, but is the highest shortly after starting the drug,” say Drs. Rob van Marum and Wilma Knol, authors of the study. They caution that “all antipsychotic drugs may be associated with pneumonia in elderly patients.”

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