Renal Impairment Following Total Joint Arthroplasty: Who Is at Risk?
Section snippets
Materials and Methods
After obtaining approval from our institutional review board, we performed this retrospective study based on the information of patients who underwent total hip or knee arthroplasty in our institution. We retrieved the patient demographics and the preoperative, intraoperative, and postoperative data from our computerized database and hospital charts. All patients who underwent TJA performed between January 2000 and December 2007, including primary or revision hip and knee surgeries, were
Results
During the study period, 98 episodes of renal impairment occurred. In this group, there were 54 (55%) knee arthroplasties including 49 primary and 5 revision surgeries; and there were 44 (45%) hip joint arthroplasties including 30 primary and 14 revision surgeries. As a result, the incidence of renal impairment was 0.55% (0.40% renal injury and 0.15% renal failure). Of these patients, 71 (72%) developed ARI and 27 (28%) developed ARF. There were 51 (52%) men and 47 (48%) women in this group,
Discussion
Acute renal impairment is a sudden and sustained decrease in renal function resulting in retention of urea and creatinine and some other waste products. This accumulation is accompanied by metabolic disturbances, such as metabolic acidosis and hyperkalemia, changes in body fluid balance, and effects on other organ systems [9]. If ARF occurs and necessitates renal replacement therapy, it increases morbidity, mortality, hospital bed use, and cost [10]. Current measures to decrease the associated
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Cited by (90)
Improving Postoperative Acute Kidney Injury Rates Following Primary Total Joint Arthroplasty
2022, Journal of Arthroplasty“Uncontrolled” Hypertension Is Not an Independent Risk Factor for Adverse Short-Term Outcomes Following Total Joint Arthroplasty
2022, Journal of ArthroplastyCitation Excerpt :Although the ROC analysis by its nature did result in “cutoff values,” these numbers are not meaningful since no statistically significant relationships were demonstrated. These results suggest that HTN, which has previously been implicated as an important contributor to orthopedic joint replacement outcomes [5,7,17,19,22,23], is likely not an isolated risk factor for complications. Although the necessity of blood pressure optimization prior to TJA remains unchallenged [7,18,19], the implication of this finding is that the current standards for what is considered uncontrolled HTN may be inappropriate and overly simplistic for use among the arthroplasty population.
Risk Factors and Effect of Acute Kidney Injury on Outcomes Following Total Hip and Knee Arthroplasty
2021, Journal of ArthroplastyDetermining the risk of acute kidney injury in patients who underwent total joint replacement: A retrospective study
2020, Journal of Orthopaedic Science
Supplementary material available at www.arthroplastyjournal.org.
No benefits or funds were received in support of this study.