Analysis of the risk factors of acute kidney injury after total hip or knee replacement surgery

Yoo Jin Lee; Bong Soo Park; Si Hyung Park; Jin Han Park; Il Hwan Kim; Jung Hae Ko; Yang Wook Kim

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자료유형: 학술저널

저자정보: Yoo Jin Lee (Department of Internal Medicine Inje University Haeundae Paik Hospital Inje University College of M) Bong Soo Park (Department of Internal Medicine Inje University Haeundae Paik Hospital Inje University College of M) Si Hyung Park (Department of Internal Medicine Inje University Haeundae Paik Hospital Inje University College of M) Jin Han Park (Department of Internal Medicine Inje University Haeundae Paik Hospital Inje University College of M) Il Hwan Kim (Department of Internal Medicine Inje University Haeundae Paik Hospital Inje University College of M) Jung Hae Ko (Department of Internal Medicine Inje University Haeundae Paik Hospital Inje University College of M) Yang Wook Kim (Department of Internal Medicine Inje University Haeundae Paik Hospital Inje University College of M)

저널정보: 영남대학교 의과대학 Journal of Yeungnam Medical Science Yeungnam University Journal of Medicine 제38권 제2호

발행연도: 2021.1

수록면: 136 - 141 (6page)

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Background: Postoperative acute kidney injury (AKI), which increases the risk of postoperative morbidity and mortality, poses a major concern to surgeons. We conducted this study to analyze the risk factors associated with the occurrence of AKI after orthopedic surgery. Methods: This was a retrospective study that included 351 patients who underwent total hip or knee replacement surgery at Inje University Haeundae Paik Hospital between January 2012 and December 2016. Results: AKI occurred in 13 (3.7%) of the 351 patients. The patients’ preoperative estimated glomerular filtration rate (eGFR) was 66.66±34.02 mL/min/1.73 m2 in the AKI group and 78.07±21.23 mL/min/1.73 m2 in the non-AKI group. The hemoglobin levels were 11.21±1.65 g/dL in the AKI group and 12.39±1.52 g/dL in the non-AKI group. Hemoglobin level was related to increased risk of AKI (odds ratio [OR], 0.13; 95% confidence interval [CI], 0.02?0.68; p=0.016). Administration of crystalloid or colloid fluid alone and the perioperative amount of fluid did not show any significant relationship with AKI. Further analysis of the changes in eGFR was performed using a cutoff value of 7.54. The changes in eGFR were significantly related to decreased risk of AKI (OR, 0.74; 95% CI, 0.61?0.89; p=0.002). Conclusion: Renal function should be monitored closely after orthopedic surgery if patients have chronic kidney disease and low hemoglobin level. Predicting the likelihood of AKI occurrence, early treatment of high-risk patients, and monitoring perioperative laboratory test results, including eGFR, will help improve patient prognosis.

#Acute kidney injury #Orthopedic procedures #Postoperative complications #Risk factors

참고문헌 (19)

참고문헌 신청

Chertow GM / 1998 / Independent association between acute renal failure and mortality following cardiac surgery / Am J Med 104:343~348

Biteker M / 2014 / Incidence, risk factors, and outcomes of perioperative acute kidney injury in noncardiac and nonvascular surgery / Am J Surg 207:53~59

White SM / 2009 / An analysis of renal dysfunction in 1511 patients with fractured neck of femur : the implications for peri-operative analgesia / Anaesthesia 64:1061~1065

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Hobson C / 2015 / Cost and mortality associated with postoperative acute kidney injury / Ann Surg 261:1207~1214

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