Acute kidney injury in patients undergoing elective primary lower limb arthroplasty

Luke Farrow; Stacey  Smillie; Joseph  Duncumb; Brian  Chan; Karen Cranfield; George Ashcroft; Iain Stevenson

doi:10.1007/s00590-021-03024-x

Acute kidney injury in patients undergoing elective primary lower limb arthroplasty

Luke Farrow^* (Corresponding Author), Stacey Smillie, Joseph Duncumb, Brian Chan, Karen Cranfield, George Ashcroft, Iain Stevenson

^*Corresponding author for this work

Research output: Contribution to journal › Article › peer-review

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6 Downloads (Pure)

Abstract

PurposeRecent research has outlined the increasing incidence of acute kidney injury (AKI) and its effect on morbidity/mortality. There is evidence that current rates are significantly under-reported nationally, with uncertainty about pre-operative factors that might influence AKI reduction and the impact on other healthcare outcomes such as mortality and later Chronic Kidney Disease (CKD) development. We set out to help address these current deficiencies in the literature.MethodsA retrospective cohort study was undertaken using data collected from patients undergoing elective primary lower limb arthroplasty within our institution from 01/10/16–31/09/17 with a 2-year follow-up.Results53/782 (6.8%) patients had an AKI during the study time period. This was associated with a longer inpatient stay (p < 0.001). There was no significant difference in 30-day mortality (p = 0.134), 30-day readmission (p = 1.00) or later CKD development (p = 0.63). Independent predictors of AKI were as follows: Diabetes (OR 2.49; 95%CI 1.15–5.38; p = 0.021), CKD (OR 4.59; 95%CI 2.37–8.92; p < 0.001) and Male sex (OR 2.61; 95%CI 1.42–4.78; p = 0.002).ConclusionsAKI in those undergoing hip and knee arthroplasty remains under-reported at a national level. AKI development was associated with an increased length of stay, but not long-term healthcare outcomes. This may be due to the mechanism of AKI development or the low absolute numbers of AKI suffered. We have identified three pre-operative factors (Diabetes, CKD & Male Sex) that were independently predictive of AKI. Targeted interventions may reduce the risk of AKI after lower limb arthroplasty.

Original language	English
Pages (from-to)	661-665
Number of pages	5
Journal	European Journal of Orthopaedic Surgery & Traumatology
Volume	32
Issue number	4
Early online date	3 Jun 2021
DOIs	https://doi.org/10.1007/s00590-021-03024-x
Publication status	Published - May 2022

Bibliographical note

Acknowledgements
The authors would like to thank Abhi Punit for his contributions in data collection towards the above article

Funding
No funds, grants or other support was received.Open access via springer agreement

Data Availability Statement

Data availability
Aggregate de-identifed data available on request

Preliminary results
Preliminary results were previously published in
abstract format and can be found here: https://online.boneandjoint.org.
uk/doi/abs/10.1302/1358-992X.2018.18.008

Keywords

Acute kidney injury
Chronic kidney disease
Arthroplasty
Orthopaedics
Hip
Knee

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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Cite this

@article{d01f408a958149efb980e6314e969f89,

title = "Acute kidney injury in patients undergoing elective primary lower limb arthroplasty",

abstract = "PurposeRecent research has outlined the increasing incidence of acute kidney injury (AKI) and its effect on morbidity/mortality. There is evidence that current rates are significantly under-reported nationally, with uncertainty about pre-operative factors that might influence AKI reduction and the impact on other healthcare outcomes such as mortality and later Chronic Kidney Disease (CKD) development. We set out to help address these current deficiencies in the literature.MethodsA retrospective cohort study was undertaken using data collected from patients undergoing elective primary lower limb arthroplasty within our institution from 01/10/16–31/09/17 with a 2-year follow-up.Results53/782 (6.8%) patients had an AKI during the study time period. This was associated with a longer inpatient stay (p < 0.001). There was no significant difference in 30-day mortality (p = 0.134), 30-day readmission (p = 1.00) or later CKD development (p = 0.63). Independent predictors of AKI were as follows: Diabetes (OR 2.49; 95%CI 1.15–5.38; p = 0.021), CKD (OR 4.59; 95%CI 2.37–8.92; p < 0.001) and Male sex (OR 2.61; 95%CI 1.42–4.78; p = 0.002).ConclusionsAKI in those undergoing hip and knee arthroplasty remains under-reported at a national level. AKI development was associated with an increased length of stay, but not long-term healthcare outcomes. This may be due to the mechanism of AKI development or the low absolute numbers of AKI suffered. We have identified three pre-operative factors (Diabetes, CKD & Male Sex) that were independently predictive of AKI. Targeted interventions may reduce the risk of AKI after lower limb arthroplasty.",

keywords = "Acute kidney injury, Chronic kidney disease, Arthroplasty, Orthopaedics, Hip, Knee",

author = "Luke Farrow and Stacey Smillie and Joseph Duncumb and Brian Chan and Karen Cranfield and George Ashcroft and Iain Stevenson",

note = "Acknowledgements The authors would like to thank Abhi Punit for his contributions in data collection towards the above article Funding No funds, grants or other support was received.Open access via springer agreement",

year = "2022",

month = may,

doi = "10.1007/s00590-021-03024-x",

language = "English",

volume = "32",

pages = "661--665",

journal = "European Journal of Orthopaedic Surgery & Traumatology",

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TY - JOUR

T1 - Acute kidney injury in patients undergoing elective primary lower limb arthroplasty

AU - Farrow, Luke

AU - Smillie, Stacey

AU - Duncumb, Joseph

AU - Chan, Brian

AU - Cranfield, Karen

AU - Ashcroft, George

AU - Stevenson, Iain

N1 - Acknowledgements The authors would like to thank Abhi Punit for his contributions in data collection towards the above article Funding No funds, grants or other support was received.Open access via springer agreement

PY - 2022/5

Y1 - 2022/5

N2 - PurposeRecent research has outlined the increasing incidence of acute kidney injury (AKI) and its effect on morbidity/mortality. There is evidence that current rates are significantly under-reported nationally, with uncertainty about pre-operative factors that might influence AKI reduction and the impact on other healthcare outcomes such as mortality and later Chronic Kidney Disease (CKD) development. We set out to help address these current deficiencies in the literature.MethodsA retrospective cohort study was undertaken using data collected from patients undergoing elective primary lower limb arthroplasty within our institution from 01/10/16–31/09/17 with a 2-year follow-up.Results53/782 (6.8%) patients had an AKI during the study time period. This was associated with a longer inpatient stay (p < 0.001). There was no significant difference in 30-day mortality (p = 0.134), 30-day readmission (p = 1.00) or later CKD development (p = 0.63). Independent predictors of AKI were as follows: Diabetes (OR 2.49; 95%CI 1.15–5.38; p = 0.021), CKD (OR 4.59; 95%CI 2.37–8.92; p < 0.001) and Male sex (OR 2.61; 95%CI 1.42–4.78; p = 0.002).ConclusionsAKI in those undergoing hip and knee arthroplasty remains under-reported at a national level. AKI development was associated with an increased length of stay, but not long-term healthcare outcomes. This may be due to the mechanism of AKI development or the low absolute numbers of AKI suffered. We have identified three pre-operative factors (Diabetes, CKD & Male Sex) that were independently predictive of AKI. Targeted interventions may reduce the risk of AKI after lower limb arthroplasty.

AB - PurposeRecent research has outlined the increasing incidence of acute kidney injury (AKI) and its effect on morbidity/mortality. There is evidence that current rates are significantly under-reported nationally, with uncertainty about pre-operative factors that might influence AKI reduction and the impact on other healthcare outcomes such as mortality and later Chronic Kidney Disease (CKD) development. We set out to help address these current deficiencies in the literature.MethodsA retrospective cohort study was undertaken using data collected from patients undergoing elective primary lower limb arthroplasty within our institution from 01/10/16–31/09/17 with a 2-year follow-up.Results53/782 (6.8%) patients had an AKI during the study time period. This was associated with a longer inpatient stay (p < 0.001). There was no significant difference in 30-day mortality (p = 0.134), 30-day readmission (p = 1.00) or later CKD development (p = 0.63). Independent predictors of AKI were as follows: Diabetes (OR 2.49; 95%CI 1.15–5.38; p = 0.021), CKD (OR 4.59; 95%CI 2.37–8.92; p < 0.001) and Male sex (OR 2.61; 95%CI 1.42–4.78; p = 0.002).ConclusionsAKI in those undergoing hip and knee arthroplasty remains under-reported at a national level. AKI development was associated with an increased length of stay, but not long-term healthcare outcomes. This may be due to the mechanism of AKI development or the low absolute numbers of AKI suffered. We have identified three pre-operative factors (Diabetes, CKD & Male Sex) that were independently predictive of AKI. Targeted interventions may reduce the risk of AKI after lower limb arthroplasty.

KW - Acute kidney injury

KW - Chronic kidney disease

KW - Arthroplasty

KW - Orthopaedics

KW - Hip

KW - Knee

U2 - 10.1007/s00590-021-03024-x

DO - 10.1007/s00590-021-03024-x

M3 - Article

SN - 1432-1068

VL - 32

SP - 661

EP - 665

JO - European Journal of Orthopaedic Surgery & Traumatology

JF - European Journal of Orthopaedic Surgery & Traumatology

IS - 4

ER -

Acute kidney injury in patients undergoing elective primary lower limb arthroplasty

Abstract

Bibliographical note

Data Availability Statement

Keywords

UN SDGs

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Cite this