Top

Clinical and Experimental Nephrology

Published in:

01-07-2020 | Acute Kidney Injury | Original article

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

Authors: Yi Ma, Kaiyun Fang, Shaopeng Gang, Jing Peng, Ling Jiang, Fujuan He, Zhenghua Wang, Li Sun, Yan Zhu

Published in: Clinical and Experimental Nephrology | Issue 7/2020

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.

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.CrossRefPubMed

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.CrossRefPubMed

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.CrossRefPubMed

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.

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.CrossRefPubMedPubMedCentral

Bihorac A, Yavas S, Subbiah S, Hobson CE, Schold JD, Gabrielli A, et al. Long-term risk of mortality and acute kidney injury during hospitalization after major surgery. Ann Surg. 2009;249(5):851–8. https://doi.org/10.1097/SLA.0b013e3181a40a0b.CrossRefPubMed

Weingarten TN, Gurrieri C, Jarett PD, Brown DR, Berntson NJ, Calaro RD, Jr. et al. Acute kidney injury following total joint arthroplasty: retrospective analysis. Canadian journal of anaesthesia = Journal canadien d'anesthesie. 2012;59(12):1111–8. doi:10.1007/s12630–012–9797–2.

Gharaibeh KA, Hamadah AM, Sierra RJ, Leung N, Kremers WK, El-Zoghby ZM. The Rate of Acute Kidney Injury After Total Hip Arthroplasty Is Low but Increases Significantly in Patients with Specific Comorbidities. The Journal of bone and joint surgery American volume. 2017;99(21):1819–26. https://doi.org/10.2106/JBJS.16.01027.CrossRefPubMed

Oh TK, Park JW, Shin HJ, Na HS, Oh AY, Hwang JW. Perioperative sedative use is not associated with acute kidney injury after total hip or knee arthroplasty. Annals of translational medicine. 2019;7(11):237. https://doi.org/10.21037/atm.2019.04.66.CrossRefPubMedPubMedCentral

10.

Kellum JA, Lameire N, Group KAGW. Diagnosis, evaluation, and management of acute kidney injury: a KDIGO summary (Part 1). Crit Care. 2013;17(1):204. https://doi.org/10.1186/cc11454.CrossRef

11.

Parvizi J, Mui A, Purtill JJ, Sharkey PF, Hozack WJ, Rothman RH. Total joint arthroplasty: When do fatal or near-fatal complications occur? The Journal of bone and joint surgery American volume. 2007;89(1):27–322. https://doi.org/10.2106/jbjs.e.01443.CrossRefPubMed

12.

Perregaard H, Damholt MB, Solgaard S, Petersen MB. Renal function after elective total hip replacement. Acta Orthop. 2016;87(3):235–8. https://doi.org/10.3109/17453674.2016.1155130.CrossRefPubMedPubMedCentral

13.

Kimmel LA, Wilson S, Janardan JD, Liew SM, Walker RG. Incidence of acute kidney injury following total joint arthroplasty: a retrospective review by RIFLE criteria. Clinical kidney journal. 2014;7(6):546–51. https://doi.org/10.1093/ckj/sfu108.CrossRefPubMedPubMedCentral

14.

Aveline C, Leroux A, Vautier P, Cognet F, Le Hetet H, Bonnet F. Risk factors for renal dysfunction after total hip arthroplasty. Ann Fr Anesth Reanim. 2009;28(9):728–34. https://doi.org/10.1016/j.annfar.2009.07.077.CrossRefPubMed

15.

Hassan BK, Sahlstrom A, Dessau RB. Risk factors for renal dysfunction after total hip joint replacement; a retrospective cohort study. Journal of orthopaedic surgery and research. 2015;10:158. https://doi.org/10.1186/s13018-015-0299-0.CrossRefPubMedPubMedCentral

16.

Bell S, Dekker FW, Vadiveloo T, Marwick C, Deshmukh H, Donnan PT, et al. Risk of postoperative acute kidney injury in patients undergoing orthopaedic surgery–development and validation of a risk score and effect of acute kidney injury on survival: observational cohort study. BMJ (Clinical research ed). 2015;351:h5639. https://doi.org/10.1136/bmj.h5639.CrossRef

17.

Kateros K, Doulgerakis C, Galanakos SP, Sakellariou VI, Papadakis SA, Macheras GA. Analysis of kidney dysfunction in orthopaedic patients. BMC nephrology. 2012;13:101. https://doi.org/10.1186/1471-2369-13-101.CrossRefPubMedPubMedCentral

18.

Porter CJ, Moppett IK, Juurlink I, Nightingale J, Moran CG, Devonald MA. Acute and chronic kidney disease in elderly patients with hip fracture: prevalence, risk factors and outcome with development and validation of a risk prediction model for acute kidney injury. BMC nephrology. 2017;18(1):20. https://doi.org/10.1186/s12882-017-0437-5.CrossRefPubMedPubMedCentral

19.

Bucaloiu ID, Kirchner HL, Norfolk ER, Hartle JE 2nd, Perkins RM. Increased risk of death and de novo chronic kidney disease following reversible acute kidney injury. Kidney Int. 2012;81(5):477–85. https://doi.org/10.1038/ki.2011.405.CrossRefPubMed

20.

Bellomo R, Ronco C, Kellum JA, Mehta RL, Palevsky P. Acute renal failure - definition, outcome measures, animal models, fluid therapy and information technology needs: the Second International Consensus Conference of the Acute Dialysis Quality Initiative (ADQI) Group. Crit Care. 2004;8(4):R204–R212212. https://doi.org/10.1186/cc2872.CrossRefPubMedPubMedCentral

21.

O'Neal JB, Shaw AD, Billings FTT. Acute kidney injury following cardiac surgery: current understanding and future directions. Crit Care. 2016;20(1):187. https://doi.org/10.1186/s13054-016-1352-z.CrossRefPubMedPubMedCentral

Title: Occurrence and predictive factors of acute renal injury following hip and knee arthroplasty
Authors: Yi Ma
Kaiyun Fang
Shaopeng Gang
Jing Peng
Ling Jiang
Fujuan He
Zhenghua Wang
Li Sun
Yan Zhu
Publication date: 01-07-2020
Publisher: Springer Singapore
Keywords: Acute Kidney Injury
Acute Kidney Injury
Published in: Clinical and Experimental Nephrology / Issue 7/2020
Print ISSN: 1342-1751
Electronic ISSN: 1437-7799
DOI: https://doi.org/10.1007/s10157-020-01874-z

ACC 2024 Congress Coverage

Heart Failure Video

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

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

Abstract

Background

Methods

Results

Conclusion

ACC 2024 Congress Coverage

Year in Review: Heart failure and cardiomyopathies

Semaglutide benefits people with type 2 diabetes and obesity-related heart failure

Incentivised to exercise

New intervention for STEMI-related cardiogenic shock

» View more highlights on the ACC 2024 congress hub page

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Background

Methods

Results

Conclusion

Please log in to get access to this content

Other articles of this Issue 7/2020

Relationship between serum calcium or phosphate levels and mortality stratified by parathyroid hormone level: an analysis from the MBD-5D study

Survey on attitudes toward brain-dead and living donor transplantation in medical students: a cross-sectional study in Japan

Pediatric glomerular hematuria: a clinicopathological study

Functional analysis of suspected splicing variants in CLCN5 gene in Dent disease 1

Determining risk factors of acute kidney injury after neonatal cardiac surgery

High-salt intake accelerates functional and histological renal damage associated with renal tissue overexpression of (pro)renin receptors and AT1 receptors in spontaneously hypertensive rats

ACC 2024 Congress Coverage

Year in Review: Heart failure and cardiomyopathies

Semaglutide benefits people with type 2 diabetes and obesity-related heart failure

Incentivised to exercise

New intervention for STEMI-related cardiogenic shock

» View more highlights on the ACC 2024 congress hub page