November 26, 2017
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Several independent risk factors linked with acute kidney injury after THA

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Although patients had a low rate of acute kidney injury after total hip arthroplasty, the rate increased significantly among patients with several independent risk factors, according to new data published in The Journal of Bone and Joint Surgery.

Rafael Sierra
Rafael J. Sierra

Rafael J. Sierra, MD, and colleagues retrospectively collected and analyzed demographic and comorbidity data for 8,949 patients who underwent THA at the Mayo Clinic between 2004 and 2014. Researchers matched patients who developed acute kidney injury to patients without acute kidney injury by age, sex and year of surgical procedure.

Of the patients who underwent THA, 1.1% developed an acute kidney injury. Of these, 79% were stage 1. Results showed older age, male gender, chronic kidney disease, heart failure, diabetes and hypertension were associated with acute kidney injury. Compared with the control group, researchers noted patients with acute kidney injury had higher BMI and baseline serum creatinine, as well as higher rates of heart failure, diabetes, hypertension and use of angiotensin converting enzyme inhibitors and angiotensin receptor blockers. However, patients who developed acute kidney injury had less use of NSAIDs.

Following this study, Sierra and colleagues developed an acute kidney injury risk calculator to help clinicians to quantify the risk of acute kidney injury in patients undergoing THA.

“The acute kidney injury calculator presented in this paper will help the orthopedic surgeon anticipate the potential risk of kidney problems after total hip arthroplasty,” Sierra told Healio.com/Orthopedics. “The data presented within this study cannot recommend against using NSAIDs after total hip arthroplasty, as there was no increased risk of acute kidney injury in patients taking those after surgery, but these were also avoided in patients deemed at high risk.” – by Casey Tingle

 

Disclosure s : The authors report no relevant financial disclosures.

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