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

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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.

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Authors and Affiliations

  1. Department of Anesthesiology, Guizhou Provincial People’s Hospital, Guiyang, 55004, Guizhou, China

    Yi Ma, Kaiyun Fang, Shaopeng Gang, Jing Peng, Ling Jiang, Fujuan He & Zhenghua Wang

  2. Department of Orthopaedics, Guizhou Provincial People’s Hospital, Guiyang, 55004, Guizhou, China

    Li Sun

  3. Department of Statistics, School of Public Health, University of Guizhou Medical University, Guiyang, 55002, Guizhou, China

    Yan Zhu

Authors
  1. Yi Ma
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  2. Kaiyun Fang
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  3. Shaopeng Gang
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  4. Jing Peng
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  5. Ling Jiang
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  6. Fujuan He
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  7. Zhenghua Wang
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  8. Li Sun
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  9. Yan Zhu
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Correspondence to Kaiyun Fang.

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Conflict of interest

The authors have no conflicts of interest to declare.

Ethical approval

The protocol was initially approved by the Medical Research Ethics Review Committee of Guizhou Provincial People’s Hospital (reference number (2019)25) and subsequently by the institutional review boards at all other participating hospitals in accordance with the Declaration of Helsinki.

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Cite this article

Ma, Y., Fang, K., Gang, S. et al. Occurrence and predictive factors of acute renal injury following hip and knee arthroplasty. Clin Exp Nephrol 24, 598–605 (2020). https://doi.org/10.1007/s10157-020-01874-z

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  • DOI: https://doi.org/10.1007/s10157-020-01874-z

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