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[Risk factors for renal dysfunction after total hip arthroplasty]
C Aveline1, A Leroux, P Vautier
1Département d'anesthésie-réanimation chirurgicale, polyclinique Sévigné, 3, rue du Chêne-Germain, 35510 Cesson-Sévigné, France. christophe.aveline@anesthesie-sevigne.com
Annales Francaises D'Anesthesie Et De Reanimation
|August 28, 2009
Summary
Postoperative renal dysfunction (PRD) is common after total hip arthroplasty (THA), particularly in older patients with existing health conditions. Limiting non-steroidal anti-inflammatory drug (NSAID) use can help prevent PRD in these individuals.
Area of Science:
- Nephrology
- Orthopedic Surgery
- Epidemiology
Context:
- Postoperative renal dysfunction (PRD) is a known complication following cardiovascular surgery.
- Data on PRD incidence and risk factors after major orthopedic surgery, such as total hip arthroplasty (THA), are limited.
- Patients undergoing THA often present with comorbidities that can impair renal function.
Purpose:
- To determine the incidence of PRD after THA.
- To identify demographic, clinical, and biological risk factors associated with PRD development post-THA.
- To provide evidence for preventative strategies in at-risk patients.
Summary:
- A prospective study of 755 patients undergoing THA assessed PRD incidence and risk factors.
- PRD was defined as a glomerular filtration rate <= 60 ml/min/1.73 m2 on postoperative day 7.
- Multivariate analysis identified preoperative renal function, elevated plasma urea, advanced age, and prolonged NSAID use as significant risk factors.
Impact:
- PRD is a common complication after THA, affecting over 30% of patients by postoperative day 7.
- Risk factors include preoperative renal impairment, elevated plasma urea, age over 70, and NSAID use exceeding 5 days.
- Findings suggest limiting NSAID duration in elderly THA patients with comorbidities to mitigate PRD risk.
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