Role of total hip replacement arthroplasty between transplantation and acute kidney injury

Figures & data

Table 1. Patient characteristics.

Variable	Transplant patients (N = 500)	Non-transplanted patients (N = 3000)	All patients (N = 3500)	p Value
Age (y)	45.21 ± 10.57	56.41 ± 14.12	55.13 ± 14.32	< 0.0001*
Weight (kg)	65.05 ± 12.45	62.59 ± 10.91	63.20 ± 11.21	0.005*
HTN	200 (40.00)	900 (30.00)	1100 (31.43)	<0.0001*
DM	60 (12.00)	450 (15.00)	510 (14.57)	0.87
IHD	40 (8.00)	310 (10.33)	350 (10.00)	0.95
CKD	150 (30.00)	107 (3.57)	257 (7.34)	<0.0001*
CVD	50 (10.00)	116 (3.87)	166 (4.74)	0.23
Anesthetic time (min)	165.15 ± 32.41	165.30 ± 51.74	162.30 ± 52.34	0.94
EBL (mL)	435.21 ± 154.52	650.61 ± 424.24	612.71 ± 402.52	<0.0001*
Total fluid during anesthesia (mL)	1854.56 ± 586.34	2386.90 ± 1873.41	2237.24 ± 1855.43	<0.0001*

Notes: Data are expressed as mean ± SD (%). Abbreviations: HTN, hypertension; DM, diabetes mellitus; IHD, ischemic heart disease; CKD, chronic kidney disease; CVD, cerebrovascular disease; EBL, estimated blood loss.

*p < 0.05, transplant versus non-transplanted patients.

Table 2. Distribution of risk factors in a propensity-matched cohort.

Variable	Transplant patients (n = 300)	Matched non-transplanted patients (n = 600)	All patients (n = 900)	p Value
Age (y)	45.04 ± 10.24	47.25 ± 16.40	46.20 ± 15.21	0.82
Weight (kg)	65.31 ± 13.20	65.53 ± 14.12	64.75 ± 13.80	0.75
HTN	120 (40.00)	240 (40.00)	360 (40.00)	0.91
DM	35 (11.67)	90 (15.00)	115 (12.78)	0.89
IHD	15 (5.00)	25 (4.17)	40 (4.45)	0.78
CKD	30 (10.00)	72 (12.00)	102 (11.33)	0.93
CVD	9 (3.00)	24 (4.00)	33 (3.67)	0.85
Anesthetic time (min)	164.71 ± 34.24	162.13 ± 83.25	160.25 ± 71.24	0.75
EBL (mL)	442.24 ± 160.21	468.10 ± 280.31	462.52 ± 226.80	0.41
Total fluid during anesthesia (mL)	1,941.49 ± 601.62	1,928.76 ± 978.08	1,932.34 ± 870.24	0.90

Notes: Data are expressed as mean ± SD or n (%).

Abbreviations as in Table 1.

Table 3. Effects of transplantation on risk of AKI in patients undergoing THRA.

	Risk estimate	Transplant patients (n = 300)	Matched non-transplanted patients (n = 600)	Odds Ratio (95% CI)	p Value
All patients	No Cr change	220 (73.33)	592 (98.67)	–	<0.0001*
	Stage I	35 (11.67)	6 (1.00)	–	–
	Stage II	5 (1.67)	4 (0.60)	–	–
	Stage III	40 (13.33)	3 (0.50)	–	–
	AKI	80 (26.67)	13 (2.1)	28.85 (10.14–82.08)	<0.001*
Within normal range of Cr	No Cr change	106 (73.61)	595 (99.17)	–	<0.0001*
	Stage I	32 (10.67)	4 (0.67)	–	–
	Stage II	2 (0.67)	0 (0.00)	–	–
	Stage III	42 (14.00)	0 (0.00)	–	–
	AKI	76 (25.33)	4 (0.67)	51.06 (12.11–215.30)	<0.0001*
CKD	No Cr change	30 (10.00)	70 (11.67)	–	0.017*
	Stage I	5 (0.17)	0 (0.00)	–	–
	Stage II	6 (2.00)	2 (0.33)	–	–
	Stage III	0 (0.00)	2 (0.33)	–	–
	AKI	10 (33.33)	4 (0.66)	6.61 (1.15–38.07)	0.032*

Notes: Data are expresses as n (%)

Abbreviations: AKI, renal function deterioration more than stage 1; THRA, total hip replacement arthroplasty; Cr, Creatinine; CKD, chronic kidney disease; CI, confidence interval.

*p < 0.05, transplant versus non-transplanted patients.

Table 4. Independent predictors of AKI in patients undergoing THRA.

Predictor	Odds Ratio	95% CI	p Value
Transplantation	31.42	11.50–89.05	<0.0001*
Gender (M/F)	0.81	0.44–1.36	0.31
Age (y)	1.07	0.89–1.14	0.43
Weight (kg)	1.15	1.05–1.12	0.04*
HTN	1.83	0.91–3.80	0.11
DM	1.12	0.35–3.22	0.96
IHD	0.83	0.14–4.56	0.87
CKD	1.35	0.51–4.31	0.58
Anesthetic time (min)	1.01	0.91–1.02	0.66
EBL (mL)	1.00	1.00–1.21	0.47
Total fluid during anesthesia (mL)	1.02	1.00–1.15	0.98

Notes: Abbreviations as in Tables 1 and 3. *p < 0.05.

Table 5. Effect of transplanted organs on the risk of AKI in patients undergoing THRA.

	Risk estimate	Transplant patients	Matched non-transplanted patients	Odds Ratio (95% CI)	p Value
Kidney (n = 400)					<0.0001*
	No Cr Change	280 (70.00)	494 (99.40)	–	–
	Stage II	10 (2.5)	1 (0.20)	–	–
	Stage III	60 (15.00)	0 (0.00)	–	–
	AKI	120 (30.00)	3 (0.60)	31.44 (9.41–105.05)	<0.0001*
Liver (n = 100)					<0.0001*
	No Cr Change	80 (80.00)	98 (98.99)	–	–
	Stage II	–	–	–	–
	Stage III	2 (2.00)	1 (1.01)	–	–
	AKI	20 (20.00)	1 (1.01)	22.25 (2.72–182.05)	<0.0001*

Notes: Data are expressed as n (%).

Abbreviations as in Table 3.

*p < 0.05 transplant versus non-transplanted patients.