title: Acute renal dysfunction following hip fracture.
abstract: We investigated the incidence, risk factors and outcome of acute renal dysfunction (ARD) in patients with a fractured neck of femur. 170 consecutive patients were prospectively included in the Scottish Hip Fracture Audit database and retrospectively analysed. Historically, lack of consensus definition has hindered accurate reporting of ARD. ARD was defined using the 'RIFLE' criteria. 27 patients (16%) developed ARD. Risk factors were male sex, vascular disease, hypertension, diabetes, chronic kidney disease and pre-morbid use of nephrotoxic medications (p<0.01). Inpatient, 30- and 120-day mortality was higher in the ARD group 19%, 22% and 41% respectively, versus 0%, 4% and 13% in the non-ARD group (p<0.01). Length of hospital stay was significantly longer in the ARD group. Pre- and post-operative complications were 12 and 5 times more frequent respectively in the ARD group (p<0.01). Awareness of risk factors and serial measurements of renal function allow early identification and focused monitoring of these patients.
authors.affiliation: Department of Trauma and Orthopaedic Surgery, Cheltenham General Hospital, Sandford Rd, Cheltenham GL53 7AN, United Kingdom. simonbennet@hotmail.com
authors.forename: Simon J
authors.initials: SJ
authors.lastname: Bennet
authors.forename: Olivia M B
authors.initials: OM
authors.lastname: Berry
authors.forename: Jane
authors.initials: J
authors.lastname: Goddard
authors.forename: John F
authors.initials: JF
authors.lastname: Keating
mesh_terms: D058186:Acute Kidney Injury / Q000145:classification / Q000453:epidemiology / Q000209:etiology*; D000368:Aged; D000369:Aged, 80 and over; D047228:Angiotensin II Type 1 Receptor Blockers / Q000009:adverse effects; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000009:adverse effects; D015897:Comorbidity; D016208:Databases, Factual; D003920:Diabetes Mellitus / Q000453:epidemiology; D005260:Female; D005265:Femoral Neck Fractures / Q000150:complications* / Q000601:surgery; D005919:Glomerular Filtration Rate / Q000502:physiology; D006620:Hip Fractures / Q000150:complications / Q000601:surgery; D017052:Hospital Mortality; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology; D012189:Retrospective Studies; D012307:Risk Factors; D012606:Scotland / Q000453:epidemiology; D014652:Vascular Diseases / Q000453:epidemiology
chemical_list: D047228:Angiotensin II Type 1 Receptor Blockers; D000806:Angiotensin-Converting Enzyme Inhibitors