Hassan Basim Kamil, Dessau Ram Benny Christian, Sahlström Arne
Department of Orthopedics, Nykoebing Falster Hospital, Fjordvej 15, 4800, Nykoebing Falster, Denmark.
Department of Clinical Microbiology, Slagelse Hospital, Faelledvej 1, 4200, Slagelse, Denmark.
J Orthop Surg Res. 2016 Oct 19;11(1):122. doi: 10.1186/s13018-016-0457-z.
Permanent renal dysfunction is considered as being a serious complication which may occur after major surgery and which furthermore may lead to increased morbidity and mortality. The objective of this study was to analyze the incidence of long-term postoperative renal dysfunction after primary total hip and knee joint replacements.
Long-term postoperative renal dysfunction was analyzed in a retrospective study of 1301 consecutive primary total hip and knee joint replacements performed between January 2009 and December 2013. According to the RIFLE criteria, increased serum creatinine was an indicative of postoperative renal injury. The highest serum creatinine during the first postoperative week was chosen as a sign for maximum acute renal injury and was compared to the highest serum creatinine during the following 4-12 months.
One hundred and forty two patients with an increase in postoperative serum creatinine were included in the follow-up study. Six patients (4.2 %) died due to non-renal causes during the follow-up period. One patient died of severe renal injury, which was relatively very early postoperatively, and another patient had a rise in serum creatinine to 316 μmol/l during the follow-up period. All the remaining 132 patients (94 %) had full recovery with serum creatinine which returned to preoperative levels.
This study did not confirm that patients who underwent primary total hip and knee joint replacement surgery were at risk of developing permanent renal dysfunction up to 1 year after the index surgery.
永久性肾功能障碍被认为是大手术后可能发生的严重并发症，进而可能导致发病率和死亡率增加。本研究的目的是分析初次全髋关节和膝关节置换术后长期肾功能障碍的发生率。
对2009年1月至2013年12月期间连续进行的1301例初次全髋关节和膝关节置换手术进行回顾性研究，分析术后长期肾功能障碍情况。根据RIFLE标准，血清肌酐升高表明术后肾损伤。术后第一周内最高血清肌酐被选作最大急性肾损伤的标志，并与接下来4至12个月内的最高血清肌酐进行比较。
142例术后血清肌酐升高的患者纳入随访研究。随访期间6例患者（4.2%）因非肾性原因死亡。1例患者死于严重肾损伤，且相对在术后早期，另1例患者在随访期间血清肌酐升至316μmol/l。其余132例患者（94%）血清肌酐均完全恢复至术前水平。
本研究未证实接受初次全髋关节和膝关节置换手术的患者在手术索引后1年内有发生永久性肾功能障碍的风险。
