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2016 ; 87
(3
): 235-8
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Renal function after elective total hip replacement
#MMPMID26937782
Perregaard H
; Damholt MB
; Solgaard S
; Petersen MB
Acta Orthop
2016[Jun]; 87
(3
): 235-8
PMID26937782
show ga
Background and purpose - Acute kidney injury (AKI) is associated with increased
short-term and long-term mortality in intensive care populations and in several
surgical specialties, but there are very few data concerning orthopedic
populations. We have studied the incidence of AKI and the prevalence of chronic
kidney disease (CKD) in an elective population of orthopedic patients undergoing
primary total hip replacement, hypothesizing that chronic kidney disease
predisposes to AKI. Patients and methods - This was a single-center,
population-based, retrospective, registry-based cohort study involving all
primary elective total hip replacements performed from January 2003 through
December 2012. Patient demographics and creatinine values were registered. We
evaluated the presence of CKD and AKI according to the international guidelines
for kidney disease (KDIGO Acute Kidney Injury Workgroup 2013 ). Results - 3,416
patients were included (2,064 females (60%)). AKI (according to KDIGO criteria)
was seen in 75 patients (2.2%, 95% CI: 1.7-2.7) in the course of primary total
hip replacement. Of these, 26 had pre-existing CKD of class 3-5. Pre-existing CKD
of class 3-5, indicating moderately to severely reduced kidney function, was seen
in 374 individuals (11%). Interpretation - Development of acute kidney injury
appears to be a substantial problem compared to other complications related to
elective total hip arthroplasty, i.e. luxation and infection. Patients with
pre-existing chronic kidney disease may be especially vulnerable. The clinical
impact of acute kidney injury in an elective orthopedic population remains to be
elucidated.
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