title: Risk factors for renal dysfunction after total hip joint replacement; a retrospective cohort study.
abstract: OBJECTIVE
  Renal injury and dysfunction are serious complications after major surgery, which may lead to increased morbidity and mortality. The objective of our study was to identify the possible risk factors for renal dysfunction after total hip joint replacement surgery.
  
  
  METHODS
  A retrospective study was conducted among 599 consecutive primary hip joint replacements performed between January 2011 and December 2013. According to the RIFLE criteria, increased postoperative serum creatinine was considered indicative of postoperative renal injury. The Welch two-sample test, chi-square test, and Fisher exact test were used for statistical analysis.
  
  
  RESULTS
  Eighty-one patients (13.8%) had significant moderate or severe postoperative renal dysfunction in which 10 patients (1.7%) acquired severe and permanent renal impairment.
  
  
  CONCLUSIONS
  We identified advanced age, hypertension, general anesthesia, high ASA scores, low intra-operative systolic BP, and prophylactic dicloxacillin as significant risk factors. Low baseline systolic BP, low baseline diastolic blood pressure, and hip fracture diagnosis were independent risk factors for postoperative increase in serum creatinine. Smoking, diabetes mellitus, high BMI, gender, and duration of surgery were not identified as significant risk factors.
authors.affiliation: Department of Orthopedics, Nykoebing Falster Hospital, Fjordvej 15, 4800, Nykoebing Falster, Denmark. basimkhassan@hotmail.com.
authors.forename: Basim Kamil
authors.initials: BK
authors.lastname: Hassan
authors.affiliation: Department of Orthopedics, Nykoebing Falster Hospital, Fjordvej 15, 4800, Nykoebing Falster, Denmark. svas@regionsjaelland.dk.
authors.forename: Arne
authors.initials: A
authors.lastname: Sahlström
authors.affiliation: Department of Clinical Microbiology, Slagelse Hospital, Ingemannsvej 18, 4200, Slagelse, Denmark. ramd@regionsjaelland.dk.
authors.forename: Ram Benny Christian
authors.initials: RB
authors.lastname: Dessau
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000768:Anesthesia, General / Q000009:adverse effects; D019644:Arthroplasty, Replacement, Hip / Q000009:adverse effects*; D015415:Biomarkers / Q000097:blood; D003404:Creatinine / Q000097:blood; D005260:Female; D006801:Humans; D006973:Hypertension / Q000150:complications; D008297:Male; D008875:Middle Aged; D051437:Renal Insufficiency / Q000175:diagnosis / Q000209:etiology*; D012189:Retrospective Studies; D012307:Risk Factors
chemical_list: D015415:Biomarkers; D003404:Creatinine