Hyponatremia and Acute Kidney Injury Following Spine Surgery.
Tommy Pan1, William Hennrikus1, Matthew Bierowski1
1Penn State College of Medicine, Penn State Milton S. Hershey Medical Center, Hershey, Pennsylvania.
Journal of Surgical Orthopaedic Advances
|May 6, 2025
Summary
Postoperative hyponatremia (38%) and acute kidney injury (7%) are common in spine surgery patients. Lower preoperative sodium and longer operative times increase hyponatremia risk, while BMI and certain medications impact AKI risk.
Area of Science:
- Nephrology
- Orthopedic Surgery
- Anesthesiology
Background:
- Postoperative hyponatremia and acute kidney injury (AKI) are potential complications following major surgical procedures.
- Spine surgery involves specific patient factors and perioperative management that may influence the incidence of these complications.
Purpose of the Study:
- To determine the incidence and identify risk factors for postoperative hyponatremia and AKI in patients undergoing spine surgery.
- To investigate the association between these complications and patient outcomes, such as length of hospital stay.
Main Methods:
- Retrospective review of 348 spine surgery patients over a 2-year period.
- Statistical analysis using bivariate and multivariable logistic regression, including odds ratios and quantile regression models.
- Data collected included preoperative laboratory values, operative details, patient demographics, and postoperative outcomes.
Main Results:
- The incidence of postoperative hyponatremia (serum sodium < 135 mEq/L) was 38% (133/348).
- The incidence of AKI (defined by creatinine increase) was 7% (24/348).
- Significant risk factors for hyponatremia included lower preoperative sodium levels and longer operative times. Body mass index and use of angiotensin receptor blockers were significant for AKI.
Conclusions:
- Postoperative hyponatremia and AKI are frequent occurrences after spine surgery.
- Identifying these risk factors can aid in proactive patient management and potentially mitigate complications.
- Patients experiencing both hyponatremia and AKI had a prolonged hospital stay, highlighting the clinical significance of these conditions.
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