AKI Incidence in Patients Undergoing Total Hip Arthroplasty

Boston—Worldwide, the number of total hip arthroplasties being performed is increasing rapidly. Sohail Abdul Salim, MD, and colleagues recently conducted a literature search and meta-analysis to examine the incidence of acute kidney injury (AKI) in patients undergoing the procedure. They reported results of the meta-analysis during a poster session at the NKF Spring Clinical Meetings in a poster titled Incidence of Acute Kidney Injury in Patients Undergoing Total Hip Arthroplasty: A Meta-Analysis.

The literature search included MEDLINE, EMBASE, and the Cochrane Database from inception until July 2018. Studies assessing the incidence of AKI in patients undergoing total hip arthroplasty were included. AKI was defined using either RIFLE (risk, injury, failure, loss of kidney function, end-stage renal disease), AKIN (Acute Kidney Injury Network), or KDIGO (Kidney Disease Improving Global Outcomes) criteria. The incidence of AKI in that patient population was estimated using a random-effects model.

The meta-analysis included 16 cohort studies representing 23,572 patients undergoing total hip arthroplasty. Overall, the pooled estimated incidence rates of AKI were 6.0% (95% confidence interval [CI], 3.6%-9.8%); the pooled estimated incidence rates of severe AKI requiring dialysis were 0.5% (95% CI, 0.1%-2.3%). The pooled estimated incidence of AKI in patients undergoing total hip arthroplasty in the United States was 2.8% (95% CI, 1.2%-6.6%).

In meta-regression of all included studies, there was significant negative correlation between incidence of AKI following total hip arthroplasty and the study year (slope=–0.37; P<.001). There was no publication bias as assessed by the funnel plot and Egger’s regression asymmetry test with P=.13 for the incidence of AKI in patients undergoing total hip arthroplasty.

“The overall estimated incidence rates of AKI and severe AKI requiring dialysis in patients undergoing total hip arthroplasty are 6.0% and 0.5%, respectively. There has been potential improvement in the AKI incidence for patients undergoing total hip arthroplasty over time,” the researchers said.

Source: Salim SA, Thongprayoobn C, Thamcharoen N, et al. Incidence of acute kidney injury in patients undergoing total hip arthroplasty: A meta-analysis. Abstract of a poster presented at the National Kidney Foundation 2019 Spring Clinical Meetings, May 8-12, 2019, Boston, Massachusetts.