Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2020 Jul;24(7):598-605.
doi: 10.1007/s10157-020-01874-z. Epub 2020 Mar 22.

Occurrence and predictive factors of acute renal injury following hip and knee arthroplasty

Yi Ma  1 , Kaiyun Fang  2 , Shaopeng Gang  1 , Jing Peng  1 , Ling Jiang  1 , Fujuan He  1 , Zhenghua Wang  1 , Li Sun  3 , Yan Zhu  4
Affiliations

Occurrence and predictive factors of acute renal injury following hip and knee arthroplasty

Yi Ma et al. Clin Exp Nephrol. 2020 Jul.

Abstract

Background: To analyze the incidence of early acute kidney injury (AKI) and perioperative factors following hip and knee joint replacement.

Methods: A total of 6281 patients from the department of orthopedics from January 2016 to July 2018 were enrolled, and 1490 patients undergoing hip and knee arthroplasty met the inclusion criteria. The preoperative, intraoperative and postoperative parameters were recorded. The retrospective cohort study was carried out to analyze predictors for AKI and postoperative creatinine elevation following hip and knee joint replacement.

Results: Eighty patients (5.4%) met AKI criteria. Age, American Society of Anesthesiologists (ASA) physical status and preoperative diabetes were identified as independent predictors for postoperative AKI in patients undergoing hip and knee arthroplasty (p < 0.05). Age, male, preoperative diabetes, hypertension, and preoperative creatinine were identified as independent predictors for postoperative creatinine elevation (p < 0.05). Patients with AKI were more likely to enter the ICU than non-AKI patients (25% vs 5.6%, p < 0.05). Compared with non-AKI patients, the total hospital stay (16 [11-22] vs 13 [10-16] days) and postoperative hospital stay (11 [8-14] vs 8 [7-11] days) for AKI patients were significantly prolonged (p < 0.05).

Conclusion: The study shows age, male, preoperative diabetes, hypertension, and preoperative creatinine were independent predictors for postoperative creatinine elevation. In addition, age, ASA physical status and preoperative diabetes are independent predictors for postoperative AKI in patients undergoing hip and knee joint replacement. Postoperative AKI seems to increase ICU admission and significantly prolonged hospital stay.

Keywords: Acute kidney injury; Hip and knee arthroplasty; Predictive factors.

PubMed Disclaimer

References

    1. Kheterpal S, Tremper KK, Englesbe MJ, O'Reilly M, Shanks AM, Fetterman DM, et al. Predictors of postoperative acute renal failure after noncardiac surgery in patients with previously normal renal function. Anesthesiology. 2007;107(6):892–902. https://doi.org/10.1097/01.anes.0000290588.29668.38 . - DOI - PubMed
    1. Chertow GM, Burdick E, Honour M, Bonventre JV, Bates DW. Acute kidney injury, mortality, length of stay, and costs in hospitalized patients. Journal of the American Society of Nephrology : JASN. 2005;16(11):3365–70. https://doi.org/10.1681/ASN.2004090740 . - DOI - PubMed
    1. Ferguson KB, Winter A, Russo L, Khan A, Hair M, MacGregor MS, et al. Acute kidney injury following primary hip and knee arthroplasty surgery. Ann R Coll Surg Engl. 2017;99(4):307–12. https://doi.org/10.1308/rcsann.2016.0324 . - DOI - PubMed
    1. Jafari SM, Huang R, Joshi A, Parvizi J, Hozack WJ. Renal impairment following total joint arthroplasty: who is at risk? The Journal of arthroplasty. 2010;25(6 Suppl):49–53, e1–2. doi:10.1016/j.arth.2010.04.008.
    1. Coca SG, Yusuf B, Shlipak MG, Garg AX, Parikh CR. Long-term risk of mortality and other adverse outcomes after acute kidney injury: a systematic review and meta-analysis. Am J Kidney Dis. 2009;53(6):961–73. https://doi.org/10.1053/j.ajkd.2008.11.034 . - DOI - PubMed - PMC

MeSH terms

LinkOut - more resources