• Aleksandra Nowicka and Thomas Selvaraj.
• Speciality registrar in anaesthesia, Warwickshire School of Anaesthesia; Department of Anaesthesia and Intensive Care, Warwick Hospital, Lakin Rd, Warwick, CV34 5BW, UK. Electronic address: a.nowicka@hotmail.com.
• J Clin Anesth. 2016 Nov 1; 34: 520-3.

Study ObjectiveThe aim of this study was to establish the incidence of acute kidney injury (AKI) in patients undergoing elective hip and knee arthroplasty.DesignThis was a retrospective cohort study.SettingThe study was conducted in a district general hospital in the United Kingdom.PatientsAll patients undergoing elective hip and knee arthroplasty over a period of 6 months were included in the study.MeasurementPreoperative and postoperative serum creatinine concentration was recorded in all patients. AKI was defined according to the Acute Kidney Injury Network classification as an increase of serum creatinine concentration of >26.5 μmol/L (≥0.3 mg/dL) or increase to 1.5-fold from baseline.Main ResultsThree hundred thirty-seven patients were included in the study. Forty-eight had preexisting stage 3 chronic kidney disease (CKD). The overall incidence of AKI in our study was 6.2%. The incidence in patients with preexisting stage 3 CKD (estimated glomerular filtration rate <60 mL/[min 1.73 m(2)]) was 16.3%, whereas in patients without preexisting stage 3 CKD, the incidence was 4.5%.ConclusionWe identified stage 3 or higher CKD as a major risk factor for developing postoperative AKI. Preexisting CKD raised the risk of developing AKI 4-fold. We recommend that all patients undergoing lower limb arthroplasty should have renal function assessed preoperatively. In the perioperative period, renal function should be monitored in all patients. This is of particular importance in patients with estimated glomerular filtration rate <60.Crown Copyright © 2016. Published by Elsevier Inc. All rights reserved.

29 keywords...

hide…