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J. Clin. Med. 2019, 8(1), 66; https://doi.org/10.3390/jcm8010066

Acute Kidney Injury in Patients Undergoing Total Hip Arthroplasty: A Systematic Review and Meta-Analysis

1
Division of Nephrology and Hypertension, Mayo Clinic, Rochester, MN 55905, USA
2
Department of Military and Community Medicine, Phramongkutklao College of Medicine, Bangkok 10400, Thailand
3
Division of Nephrology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA 02215, USA
4
Department of Internal Medicine, University of Arizona, Tucson, AZ 85721, USA
5
Department of Internal Medicine, Bassett Medical Center, Cooperstown, NY 13326, USA
6
Division of Nephrology, Department of Medicine, University of Mississippi Medical Center, Jackson, MS 39216, USA
7
Clinical Epidemiology Unit, Department of Research and Development, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand
8
Division of Nephrology, Department of Medicine, Deaconess Health System, Evansville, IN 47747, USA
*
Author to whom correspondence should be addressed.
Received: 15 December 2018 / Revised: 8 January 2019 / Accepted: 8 January 2019 / Published: 9 January 2019
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Abstract

Background: The number of total hip arthroplasties (THA) performed across the world is growing rapidly. We performed this meta-analysis to evaluate the incidence of acute kidney injury (AKI) in patients undergoing THA. Methods: A literature search was performed using MEDLINE, EMBASE and Cochrane Database from inception until July 2018 to identify studies assessing the incidence of AKI (using standard AKI definitions of RIFLE, AKIN, and KDIGO classifications) in patients undergoing THA. We applied a random-effects model to estimate the incidence of AKI. The protocol for this meta-analysis is registered with PROSPERO (no. CRD42018101928). Results: Seventeen cohort studies with a total of 24,158 patients undergoing THA were enrolled. Overall, the pooled estimated incidence rates of AKI and severe AKI requiring dialysis following THA were 6.3% (95% CI: 3.8%–10.2%) and 0.5% (95% CI: 0.1%–2.3%). Subgroup analysis based on the countries by continent was performed and demonstrated the pooled estimated incidence of AKI following THA of 9.2% (95% CI: 5.6%–14.8%) in Asia, 8.1% (95% CI: 4.9%–13.2%) in Australia, 7.4% (95% CI: 3.2%–16.3%) in Europe, and 2.8% (95% CI: 1.2%–17.0%) in North America. Meta-regression of all included studies showed significant negative correlation between incidence of AKI following THA and study year (slope = −0.37, p <0.001). There was no publication bias as assessed by the funnel plot and Egger’s regression asymmetry test with p = 0.13 for the incidence of AKI in patients undergoing THA. Conclusion: The overall estimated incidence rates of AKI and severe AKI requiring dialysis in patients undergoing THA are 6.3% and 0.5%, respectively. There has been potential improvement in AKI incidence for patients undergoing THA over time. View Full-Text
Keywords: acute kidney injury; acute renal failure; hip arthroplasty; hip Surgery; postoperative acute kidney injury; incidence; epidemiology; systematic reviews; meta-analysis acute kidney injury; acute renal failure; hip arthroplasty; hip Surgery; postoperative acute kidney injury; incidence; epidemiology; systematic reviews; meta-analysis
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Thongprayoon, C.; Kaewput, W.; Thamcharoen, N.; Bathini, T.; Watthanasuntorn, K.; Salim, S.A.; Ungprasert, P.; Lertjitbanjong, P.; Aeddula, N.R.; Torres-Ortiz, A.; Mao, M.A.; Cheungpasitporn, W. Acute Kidney Injury in Patients Undergoing Total Hip Arthroplasty: A Systematic Review and Meta-Analysis. J. Clin. Med. 2019, 8, 66.

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