Is there a risk of permanent renal dysfunction after primary total hip and knee joint replacements?

Basim Kamil Hassan, Ram Benny Christian Dessau, Arne Sahlström

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.