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 journalArticlepeer-review

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 languageEnglish
JournalEuropean Journal of Orthopaedic Surgery & Traumatology
Early online date3 Jun 2021
DOIs
Publication statusE-pub ahead of print - 3 Jun 2021

Keywords

  • Acute kidney injury
  • Chronic kidney disease
  • Arthroplasty
  • Orthopaedics
  • Hip
  • Knee

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