The prevalence and risk factors of acute kidney injury in post-orthopedic surgery patients.

PURPOSE: This study aimed to investigate the prevalence and identify the risk factors associated with acute kidney injury (AKI) in patients undergoing orthopedic surgery.

METHODS

A retrospective study was conducted on 2,796 patients admitted to the orthopedic ward for bone tumors, bone injuries, and spinal diseases between 2017 and 2020. Patients were categorized into non-AKI, AKI stage 1-2, and AKI stage 3 groups. Data were analyzed using chi-square, Fisher's exact, Kruskal-Wallis tests, and logistic regression to compare groups and determine independent risk factors for AKI.

RESULTS

AKI occurred in 97 patients, yielding an overall prevalence of 3.47%. The incidence was highest among patients undergoing bone tumor surgery (11.36%) and lowest in those undergoing spinal surgery (2.46%). Patients in the AKI stage 3 group had a significantly higher proportion of bone tumor surgeries and longer hospital stays compared to other groups (P < 0.001). Multivariate analysis identified bone tumor surgery, preoperative proteinuria, elevated urea, decreased hemoglobin, and the use of proton pump inhibitors (PPIs) and non-steroidal anti-inflammatory drugs (NSAIDs) as independent risk factors for AKI.

CONCLUSION

There is a significant risk of AKI following orthopedic surgery, particularly in patients undergoing bone tumor procedures. The study underscores several key modifiable risk factors, including the use of PPIs and NSAIDs, as well as preoperative conditions like proteinuria, anemia, and elevated urea.