title: Which patients are at risk for kidney dysfunction after hip fracture surgery?
abstract: BACKGROUND
  Kidney dysfunction (KD) after hip fracture surgery is a major complication. However, the incidence and risk factors of KD in this population are unclear.
  
  
  OBJECTIVE
  We therefore (1) determined the incidence of KD in a large cohort of fracture patients, (2) identified preoperative risk factors predisposing to KD, and (3) determined the effect of KD on length of stay and subsequent function.
  
  
  METHODS
  Between April 2011 and June 2012, 450 patients (263 women) with a mean age of 73 years (range, 67-96 years) underwent surgery for hip fracture in our institution. We calculated incidence and retrospectively reviewed suspected predisposing risk factors. We report followup at 6 months.
  
  
  RESULTS
  The overall incidence of KD was 11% (n = 52). Forty-five patients (86%) developed acute KD and seven patients developed acute-on-chronic KD. Three of the 52 patients died during the followup time. Thirty-eight of the 52 patients (73%) regained their prior kidney function after treatment. An increased risk of KD was found in those with diabetes, shock during or after surgery, age, and preexisting KD. Mean length of stay was higher for patients with KD compared to those without: 9.6 versus 7.4, respectively. At 6 months, 39 of the 49 surviving patients (80%) were fully weightbearing.
  
  
  CONCLUSIONS
  Many patients at risk for postoperative KD can be identified and treated. Most patients recover from their KD and the majority return to full weightbearing.
authors.affiliation: Department of Orthopaedics and Trauma, KAT Hospital, 2 Nikis Street, 145 61, Kifisia, Attiki, Hellas, gmacheras@gmail.com.
authors.forename: George A
authors.initials: GA
authors.lastname: Macheras
authors.forename: Konstantinos
authors.initials: K
authors.lastname: Kateros
authors.forename: Stefanos D
authors.initials: SD
authors.lastname: Koutsostathis
authors.forename: Stamatios A
authors.initials: SA
authors.lastname: Papadakis
authors.forename: Eleftherios
authors.initials: E
authors.lastname: Tsiridis
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D003924:Diabetes Mellitus, Type 2 / Q000150:complications; D005260:Female; D005593:Fracture Fixation, Internal / Q000009:adverse effects* / Q000706:statistics & numerical data; D005594:Fracture Fixation, Intramedullary / Q000009:adverse effects / Q000706:statistics & numerical data; D005919:Glomerular Filtration Rate / Q000502:physiology; D006620:Hip Fractures / Q000150:complications / Q000601:surgery*; D006621:Hip Joint / Q000601:surgery; D006801:Humans; D015994:Incidence; D007668:Kidney / Q000503:physiopathology; D007674:Kidney Diseases / Q000453:epidemiology / Q000209:etiology* / Q000503:physiopathology; D007902:Length of Stay; D008297:Male; D012189:Retrospective Studies; D012307:Risk Factors; D016896:Treatment Outcome