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Chronic Kidney Diseases Among Patients Undergoing Elective Arthroplasty: Risk Groups and the Value of Serum
Pyry P Jämsä1, Niku K J Oksala2, Antti P Eskelinen3
1Coxa Hospital for Joint Replacement, Tampere, Finland; Faculty of Medicine and Life Sciences, University of Tampere, Tampere, Finland.
Background:
In arthroplasty clinics, we tend to evaluate patient's kidney function looking at serum creatinine (SCr), while estimated glomerular filtration rate (eGFR) is recommended. We reported the prevalence of chronic kidney disease (CKD; eGFR <60 mL/min/1.73 m2) in different patient groups and investigated whether CKD is missed by evaluation based on SCr.
Methods:
Preoperative SCr values were used to calculate eGFR in 20,575 consecutive hip or knee arthroplasties.
Results:
Prevalence of CKD was 9%-12%. It was higher among older women, knee arthroplasty patients, and patients with hypertension, diabetes, or coronary disease. Using SCr instead of eGFR leads to missing CKD in up to 7% of the cases. In older women and older patients with body mass index <25 kg/m2, half of CKD cases were missed.
Conclusion:
Use of eGFR instead of SCr to detect CKD more accurately is recommended.
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