TABLE 1

Studies reporting the incidence of acute kidney injury using current diagnostic criteria

Study	No. of patients	Joints involved	Definition of AKI	Incidence of AKI	Risk factors for AKI	Comments
Jafari⁷	17,938	Hip, knee	“I” or “F” of RIFLE criteria	0.55%	BMI, chronic kidney disease, hypertension, COPD, heart failure, heart disease, liver disease	Neglected the most common “R” criteria
Jamsa⁸	20,575	Hip, knee	“I” or “F” of RIFLE	0.28%	Preoperative estimated glomerular filtration rate, ASA score, BMI	Only 5,609 had postoperative serum creatinine measured
Sehgal⁹	659	Knee	AKIN	21.9%	RASB, diabetes	Not independent risk factors
Weingarten¹⁰	7,463	Hip, knee, shoulder	AKIN	2.2%	BMI, diabetes, PAD, perioperative transfusion, number of antihypertensive medications	93% of AKI cases were only stage 1
Kimmel¹¹	425	Hip, knee	RIFLE	14.8%	Age, BMI, chronic kidney disease, RASB
Warth¹²	1,038	Hip, knee	AKIN	5.7%	Age, BMI, diabetes, smoking	AKI in 4.8% of 903 with serum creatinine < 1.2 mg/dL vs 11% if ≥ 1.2
Perregaard¹³	3,410	Hip	KDIGO	2.2%	Chronic kidney disease	AKI in 7% of 374 patients; 11% with chronic kidney disease
Hassan¹⁴	599	Hip	RIFLE	13.8%	Age, hypertension, general anesthesia, dicloxicillin, low baseline blood pressure	1.7% became permanent dialysis patients
Nowicka¹⁵	337	Hip, knee	AKIN	6.2%	Chronic kidney disease	AKI in 16.7% with chronic kidney disease vs 4.5% without
Kim¹⁶	1,309	Knee	KDIGO	4.4%	Age, diabetes, beta-blockers, diuretics, low albumin	Highlights risk of low postoperative albumin
Choi¹⁷	2,467	Hip	AKIN	4.82%	Postoperative hemoglobin < 10 g/dL	Highlights risk of anemia
Nielson¹⁸	798	Hip, knee, spinal fusion	KDIGO	4.26%	RASB, BMI, intraoperative hypotension	Highlights risk of RASB
Courtney¹⁹	1,828	Hip, knee	AKIN	11.3%	Vancomycin, ASA score, reduced glomerular filtration rate	AKI in 13% if vancomycin given
Dubrovskaya²⁰	4,177	Hip, knee, spine (1,502)	RIFLE	2.8% (hip and knee)	Diabetes, knee or hip surgery (vs spine)	Not associated with prophylactic gentamicin
Bell²¹	7,666	Hip, knee	KDIGO	7.14%	Gentamicin/flucloxacillin vs cefuroxime prophylaxis	Highlights risk of gentamicin/flucloxacillin
Ross²²	273	Hip, knee	RIFLE	4%	Gentamicin/flucloxacillin vs cefuroxime prophylaxis	Highlights risk of gentamicin/flucloxacillin
Bailey²³	238	Hip, knee	RIFLE	5.7%	Gentamicin/flucloxacillin vs cefuroxime prophylaxis	Highlights risk of gentamicin/flucloxacillin
Challagundla²⁴	198	Hip, knee	RIFLE	23.7%	Male sex, RASB, high-dose gentamicin/flucloxacillin vs cefuroxime prophylaxis	Highlights risk of gentamicin/flucloxacillin; AKI in 52% of 52 receiving high-dose gentamicin/flucloxacillin
Johansson²⁵	136	Hip	KDIGO	20%	Gentamicin/dicloxacillin vs dicloxacillin	Highlights risk of gentamicin
Ferguson²⁶	413	Hip, knee	RIFLE	8%	Age, volume of postoperative fluid	RASB and gentamicin not significant
Bjerregaard²⁷	1,213	Hip, knee	KDIGO	3.5%	Chronic kidney disease, postoperative hypotension	Only considered the 1,213 patients with prolonged length of stay or 30-day readmission
Friedman²⁸	345	Hip, knee	KDIGO	6.3%	Preoperative murmurs, age	Odds ratio 7.73 (P < .001) for AKI if preoperative murmur

AKI = acute kidney injury; AKIN = Acute Kidney Injury Network; ASA = American Society of Anesthesiologists; BMI = body mass index; COPD = chronic obstructive pulmonary disease; KDIGO = Kidney Disease Improving Global Outcomes; PAD = peripheral artery disease; RASB = renin-angiotensin system blockade (angiotensin-converting enzyme inhibitor or angiotensin II receptor blocker); RIFLE = risk, injury, failure, loss, end-stage kidney disease