Abstract
We investigated the incidence, risk factors and outcome of acute renal dysfunction
(ARD) in patients with a fractured neck of femur.
170 consecutive patients were prospectively included in the Scottish Hip Fracture
Audit database and retrospectively analysed. Historically, lack of consensus definition
has hindered accurate reporting of ARD. ARD was defined using the ‘RIFLE’ criteria.
27 patients (16%) developed ARD. Risk factors were male sex, vascular disease, hypertension,
diabetes, chronic kidney disease and pre-morbid use of nephrotoxic medications (p < 0.01). Inpatient, 30- and 120-day mortality was higher in the ARD group 19%, 22% and
41% respectively, versus 0%, 4% and 13% in the non-ARD group (p < 0.01). Length of hospital stay was significantly longer in the ARD group. Pre- and
post-operative complications were 12 and 5 times more frequent respectively in the
ARD group (p < 0.01).
Awareness of risk factors and serial measurements of renal function allow early identification
and focused monitoring of these patients.
Keywords
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Article info
Publication history
Accepted:
July 13,
2009
Identification
Copyright
© 2009 Elsevier Ltd. Published by Elsevier Inc. All rights reserved.
