The prevalence and risk factors of acute kidney injury in patients undergoing hip fracture surgery: a meta-analysis

ABSTRACT

Acute kidney injury (AKI) was a frequent complication following hip fracture surgery, but recent studies reported inconsistent findings. Our study was aimed at clarifying the prevalence and risk factors of AKI after hip fracture surgery. Pubmed, Embase, and Web of Science were systematically searched from the inception to March 2020 to identify observational studies investigating the prevalence and risk factors of AKI in patients undergoing hip fracture surgery. Pooled prevalence and odds ratios (ORs) with 95% confidence intervals (CIs) were estimated using a random-effects model. Publication bias was evaluated with a funnel plot and statistical test. All the statistical analyses were performed using Stata version 12.0. A total of 11 studies with 16,421 patients was included in the current meta-analysis. The pooled prevalence of AKI in patients undergoing hip fracture surgery was 17% (95%CI, 14%-21%) with substantial heterogeneity (I² = 95%). Postoperative serum albumin (OR 1.80; 95%CI, 1.38–2.36) was a significant predictor for AKI. Age (OR 1.01; 95%CI, 0.95–1.07) and ACE inhibitors (OR 1.38; 95%CI, 0.92–2.07) were associated with increased the risk of AKI, but the results were not statistically significant. No significant publication bias was identified through statistical tests (Egger’s test, p = 0.258 and Begg’s test, p = 0.087). In conclusion, our findings indicated that the pooled AKI following hip fracture surgery was approximately 17%. Postoperative serum albumin was a potential significant risk factor for AKI.

GRAPHICAL ABSTRACT

KEYWORDS:

• Acute kidney injury
• prevalence
• risk factor
• hip fracture
• meta-analysis

Highlight

1. The pooled prevalence of AKI following hip fracture surgery was approximately 17%.

2. Postoperative serum albumin was a significant risk factor for AKI following hip fracture surgery.

3. Age and ACE inhibitors may be potential risk factors of AKI following hip fracture surgery.

Abbreviations

AKI: Acute kidney injury; CI: Confidence interval; OR: odds ratio

Acknowledgements

Thanks Research Square for showing our manuscript in the pre-print website (10.21203/rs.3.rs-29764/v1).

Disclosure of potential conflicts of interest

The author(s) declare that they have no competing interests.

Author contributions

Zi-Cai Li and Yan-Chuang Pu designed this meta-analysis. Zi-Cai Li, Yan-Chuang, Pu, Hu-Lin Wang, and Jin Wang performed study selection and extracted data. Jin Wang, Yan-Li Zhang, and Hu-Lin Wang performed statistical analysis. Zi-Cai Li and Yan-Chuang Pu wrote this manuscript.

Ethics approval and consent to participate

This article does not contain any studies with human participants or animals performed by any of the authors