title: Analysis of kidney dysfunction in orthopaedic patients.
abstract: BACKGROUND
  This retrospective study was undertaken to determine the incidence of kidney dysfunction (KD) and to identify potential risk factors contributing to development of KD in orthopaedic population following an elective or emergency surgery.
  
  
  METHODS
  A total of 1025 patients were admitted in our institution over a period of one year with various indications. Eight hundred and ninety-three patients (87.1%) had a surgical procedure. There were 42 (52.5%) male and 38 (47.5%) female with a mean age of 72  years (range: 47 to 87  years). We evaluated the following potential risk factors: age, comorbidities, shock, hypotension, heart failure, medications (antibiotics, NSAIDs, opiates), rhabdomyolysis, imaging contrast agents and pre-existing KD.
  
  
  RESULTS
  The overall incidence of KD was 8.9%. Sixty-eight patients developed acute renal injury (AKI) and 12 patients developed acute on chronic kidney disease (CKD). In sixty-six (82.5%) patients renal function was reversed to initial preoperative status. Perioperative dehydration (p = 0.002), history of diabetes mellitus (p = 0.003), pre-existing KD (p = 0.004), perioperative shock (p = 0.021) and administration of non-steroid anti-inflammatory drugs (NSAIDs) (p = 0.028) or nephrotoxic antibiotics (p = 0.037) were statistically significantly correlated with the development of postoperative KD and failure to gain the preoperative renal function.
  
  
  CONCLUSIONS
  We conclude that every patient with risk factor for postoperative KD should be under closed evaluation and monitoring.
authors.affiliation: Department of Trauma and Orthopaedics, General Hospital of Levadia, Levadia, Greece. kkateros@hotmail.com
authors.forename: Konstantinos
authors.initials: K
authors.lastname: Kateros
authors.forename: Christos
authors.initials: C
authors.lastname: Doulgerakis
authors.forename: Spyridon P
authors.initials: SP
authors.lastname: Galanakos
authors.forename: Vasileios I
authors.initials: VI
authors.lastname: Sakellariou
authors.forename: Stamatios A
authors.initials: SA
authors.lastname: Papadakis
authors.forename: George A
authors.initials: GA
authors.lastname: Macheras
mesh_terms: D058186:Acute Kidney Injury / Q000175:diagnosis / Q000453:epidemiology*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015984:Causality; D015897:Comorbidity; D005260:Female; D006115:Greece / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D019637:Orthopedic Procedures / Q000706:statistics & numerical data*; D051436:Renal Insufficiency, Chronic / Q000175:diagnosis / Q000453:epidemiology*; D018570:Risk Assessment