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

StudyNo. of patientsJoints involvedDefinition of AKIIncidence of AKIRisk factors for AKIComments
Jafari717,938Hip, knee“I” or “F” of RIFLE criteria0.55%BMI, chronic kidney disease, hypertension, COPD, heart failure, heart disease, liver diseaseNeglected the most common “R” criteria
Jamsa820,575Hip, knee“I” or “F” of RIFLE0.28%Preoperative estimated glomerular filtration rate, ASA score, BMIOnly 5,609 had postoperative serum creatinine measured
Sehgal9659KneeAKIN21.9%RASB, diabetesNot independent risk factors
Weingarten107,463Hip, knee, shoulderAKIN2.2%BMI, diabetes, PAD, perioperative transfusion, number of antihypertensive medications93% of AKI cases were only stage 1
Kimmel11425Hip, kneeRIFLE14.8%Age, BMI, chronic kidney disease, RASB
Warth121,038Hip, kneeAKIN5.7%Age, BMI, diabetes, smokingAKI in 4.8% of 903 with serum creatinine < 1.2 mg/dL vs 11% if ≥ 1.2
Perregaard133,410HipKDIGO2.2%Chronic kidney diseaseAKI in 7% of 374 patients; 11% with chronic kidney disease
Hassan14599HipRIFLE13.8%Age, hypertension, general anesthesia, dicloxicillin, low baseline blood pressure1.7% became permanent dialysis patients
Nowicka15337Hip, kneeAKIN6.2%Chronic kidney diseaseAKI in 16.7% with chronic kidney disease vs 4.5% without
Kim161,309KneeKDIGO4.4%Age, diabetes, beta-blockers, diuretics, low albuminHighlights risk of low postoperative albumin
Choi172,467HipAKIN4.82%Postoperative hemoglobin < 10 g/dLHighlights risk of anemia
Nielson18798Hip, knee, spinal fusionKDIGO4.26%RASB, BMI, intraoperative hypotensionHighlights risk of RASB
Courtney191,828Hip, kneeAKIN11.3%Vancomycin, ASA score, reduced glomerular filtration rateAKI in 13% if vancomycin given
Dubrovskaya204,177Hip, knee, spine (1,502)RIFLE2.8% (hip and knee)Diabetes, knee or hip surgery (vs spine)Not associated with prophylactic gentamicin
Bell217,666Hip, kneeKDIGO7.14%Gentamicin/flucloxacillin vs cefuroxime prophylaxisHighlights risk of gentamicin/flucloxacillin
Ross22273Hip, kneeRIFLE4%Gentamicin/flucloxacillin vs cefuroxime prophylaxisHighlights risk of gentamicin/flucloxacillin
Bailey23238Hip, kneeRIFLE5.7%Gentamicin/flucloxacillin vs cefuroxime prophylaxisHighlights risk of gentamicin/flucloxacillin
Challagundla24198Hip, kneeRIFLE23.7%Male sex, RASB, high-dose gentamicin/flucloxacillin vs cefuroxime prophylaxisHighlights risk of gentamicin/flucloxacillin; AKI in 52% of 52 receiving high-dose gentamicin/flucloxacillin
Johansson25136HipKDIGO20%Gentamicin/dicloxacillin vs dicloxacillinHighlights risk of gentamicin
Ferguson26413Hip, kneeRIFLE8%Age, volume of postoperative fluidRASB and gentamicin not significant
Bjerregaard271,213Hip, kneeKDIGO3.5%Chronic kidney disease, postoperative hypotensionOnly considered the 1,213 patients with prolonged length of stay or 30-day readmission
Friedman28345Hip, kneeKDIGO6.3%Preoperative murmurs, ageOdds 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