DOS Kongressen 2014 ·
201
Prevalence of kidney dysfunction at elective total
hip arthroplasty operations.
Helene Berg-Nielsen, Morten Boye Petersen, Mette Brimnes Damholt,
Søren Solgaard
Lægevidenskab, Københavns Universitet; Ortopædkirurgisk afdeling, Gentofte
Hospital; Nefrologisk afdeling, Rigshospitalet
Background:
Previous studies in other surgical specialties have shown a clear
correlation between even small increases in plasma Creatinine (pCr), develop-
ment of Acute Kidney Injury (AKI) and increased long-term mortality.
Purpose / Aim of Study:
To investigate pre-operative kidney function as es-
timated glomerular filtration rate (eGFR) and the occurrence of AKI amongst a
population undergoing elective hip arthroplasty.
Materials and Methods:
The study is a single-center, retrospective, register-
based cohort study including all primary, elective, total hip replacement surger-
ies (THA) carried out in Hørsholm and Gentofte hospitals from Jan. 2000 to
Dec. 2012. Presence of AKI and eGFR was evaluated on basis of international
KDIGO criteria.
Findings / Results:
5687 operations were performed in 4909 patients. Only
the first THA for each person was considered. Pre-operative pCr (< 3 months
pre operation) could be obtained for 3328 persons (68 %); 2014 females and
1314 males; age 68,6 ± 10,1 years (mean±SD). In this population kidney func-
tion was moderately to severely decreased (eGFR < 59 ml/min) (CKD 3-5) in
11,9 % of the patients. Both pre- and postoperative pCr (one value within three
days after operation) could be obtained in 2388 persons (49% of patients).
Development of AKI based on an increase in pCr was seen in 35 persons (1,5
%) in this population.
Conclusions:
Decreased kidney function seems to be prevalent in an elective
orthopedic population. Data is not sufficient to evaluate whether AKI is preva-
lent in this population, but 1,5 % of the patients, who could be evaluated, meet
criteria for development of acute kidney injury. If we are to determine the im-
pact of AKI in orthopedic patients, measuring pCr should be part of the standard
postoperative observation. Further studies are ongoing.
148.
