دورية أكاديمية
أعرض في EDS

Greater Rates of Acute Kidney Injury in African American Total Knee Arthroplasty Patients.

التفاصيل البيبلوغرافية
العنوان: Greater Rates of Acute Kidney Injury in African American Total Knee Arthroplasty Patients.
المؤلفون: Womble TN; Department of Orthopaedic Surgery and Sports Medicine, University of Kentucky, Lexington, KY., King JD; Department of Orthopaedic Surgery and Sports Medicine, University of Kentucky, Lexington, KY., Hamilton DH; Department of Orthopaedic Surgery and Sports Medicine, University of Kentucky, Lexington, KY., Shrout MA; Department of Orthopaedic Surgery and Sports Medicine, University of Kentucky, Lexington, KY., Jacobs CA; Department of Orthopaedic Surgery and Sports Medicine, University of Kentucky, Lexington, KY., Duncan ST; Department of Orthopaedic Surgery and Sports Medicine, University of Kentucky, Lexington, KY.
المصدر: The Journal of arthroplasty [J Arthroplasty] 2019 Jun; Vol. 34 (6), pp. 1240-1243. Date of Electronic Publication: 2019 Jan 31.
نوع المنشور: Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't
اللغة: English
بيانات الدورية: Publisher: Taylor and Francis Country of Publication: United States NLM ID: 8703515 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1532-8406 (Electronic) Linking ISSN: 08835403 NLM ISO Abbreviation: J Arthroplasty Subsets: MEDLINE
أسماء مطبوعة: Publication: New Brunswick, NJ : Taylor and Francis
Original Publication: [New York, NY : Churchill Livingstone, c1986-
مواضيع طبية MeSH: Black or African American*, Acute Kidney Injury/*complications , Acute Kidney Injury/*ethnology , Arthroplasty, Replacement, Knee/*adverse effects , Osteoarthritis, Knee/*complications , Osteoarthritis, Knee/*ethnology, Adult ; Aged ; Antimicrobial Stewardship ; Creatinine/blood ; Female ; Hispanic or Latino ; Hospitalization ; Hospitals ; Humans ; Male ; Middle Aged ; Osteoarthritis, Knee/surgery ; Postoperative Period ; Preoperative Period ; Prevalence ; Prosthesis-Related Infections/ethnology ; Prosthesis-Related Infections/etiology ; Retrospective Studies ; Vancomycin/adverse effects ; White People
مستخلص: Background: This retrospective study compared the change in serum creatinine between African American and Caucasian total knee arthroplasty (TKA) patients. The authors hypothesized that African Americans would demonstrate significantly greater change, and that a significantly greater proportion would demonstrate creatinine changes consistent with acute kidney injury (AKI).
Methods: Primary TKAs performed at a single institution between July 2011 and June 2016 were identified: 1035 primary TKAs met inclusion and exclusion criteria (110 African American, 925 Caucasian, excluding Hispanic and Asian patients). None were excluded based on gender, age, body mass index, preoperative diagnosis, or comorbidities. All patients had preoperative and postoperative creatinine levels available in the electronic medical records. Each patient received the same preop and postop protocol for nonsteroidal anti-inflammatory drug use along with other drugs administered including anesthesia. All patients received 1 g of intravenous vancomycin with some patients additionally receiving 1 g of vancomycin powder administered locally at the end of surgery. All patients were controlled for fluid intake and blood loss, along with no patient receiving a transfusion or intravenous contrast. Patient demographics and preoperative/postoperative serum creatinine were recorded and then analyzed for presence of AKI (≥0.3 mg/dL). Preoperative/postoperative serum creatinine concentrations were compared between African American and Caucasian patients using 2 × 2 repeated measures analysis of variance. Prevalence of patients in each group demonstrating AKI was calculated using Fisher's exact test.
Results: African American patients had significantly greater serum creatinine preoperatively (1.00 ± 0.26 vs 0.90 ± 0.22, P < .001) and a significantly greater increase postoperatively (0.10 vs 0.03, P < .001). A significantly greater number of African American patients demonstrated AKI (10.9% vs 5.1%, P = .03). Furthermore, a significantly greater number of African American patients stayed in the hospital an additional 2 or more days for renal issues (2.7% vs 0.4%, P = .03).
Conclusion: Altered renal function was significantly more common in African American TKA patients. Future studies are necessary to determine if tailoring anti-inflammatories, perioperative medications, and preoperative comorbidities reduce the risk of renal injury and/or a longer hospital stay for this subset of patients.
(Copyright © 2019 Elsevier Inc. All rights reserved.)
References: Anesth Analg. 2005 Mar;100(3):636-44, table of contents. (PMID: 15728043)
Clin Orthop Relat Res. 2015 Jul;473(7):2283-90. (PMID: 25690169)
J Rheumatol. 2006 Nov;33(11):2271-9. (PMID: 17013996)
J Arthroplasty. 2018 Dec;33(12):3783-3788. (PMID: 30224099)
J Bone Joint Surg Am. 2001 Aug;83(8):1157-61. (PMID: 11507123)
J Arthroplasty. 2008 Oct;23(7):984-91. (PMID: 18534466)
Cleve Clin J Med. 2012 Oct;79(10):726-34. (PMID: 23027732)
Ann Surg. 2020 Jan;271(1):114-121. (PMID: 29864092)
Infect Dis Clin North Am. 2005 Dec;19(4):931-46. (PMID: 16297740)
Clin Orthop Relat Res. 2015 Jul;473(7):2197-203. (PMID: 25421958)
J Multidiscip Healthc. 2018 Jan 25;11:63-73. (PMID: 29416347)
J Arthroplasty. 2017 Mar;32(3):728-734.e1. (PMID: 27823845)
J Am Soc Nephrol. 2015 Jul;26(7):1682-92. (PMID: 25349204)
Ann Thorac Surg. 2008 Oct;86(4):1160-5. (PMID: 18805152)
Clin Orthop Relat Res. 1997 Dec;(345):99-105. (PMID: 9418626)
Mayo Clin Proc. 1997 Sep;72(9):799-805. (PMID: 9294525)
Clin Orthop Relat Res. 1999 Dec;(369):39-48. (PMID: 10611859)
Ther Clin Risk Manag. 2018 Oct 31;14:2149-2159. (PMID: 30464488)
Nephron Clin Pract. 2012;120(4):c179-84. (PMID: 22890468)
Kidney Int. 2015 Jan;87(1):46-61. (PMID: 25229340)
Clin J Am Soc Nephrol. 2007 May;2(3):426-30. (PMID: 17699447)
Anesth Analg. 2001 Nov;93(5):1111-5. (PMID: 11682377)
Anesth Analg. 1995 Mar;80(3):480-5. (PMID: 7864411)
J Am Soc Nephrol. 2005 Nov;16(11):3365-70. (PMID: 16177006)
J Arthroplasty. 2012 Sep;27(8 Suppl):61-5.e1. (PMID: 22554729)
J Racial Ethn Health Disparities. 2019 Feb;6(1):101-109. (PMID: 29916191)
Clin Orthop Relat Res. 2014 Jan;472(1):57-65. (PMID: 23666589)
Ann Thorac Surg. 2005 Oct;80(4):1388-93; discussion 1393. (PMID: 16181876)
J Arthroplasty. 2017 Sep;32(9S):S91-S96. (PMID: 28341280)
Arthroplast Today. 2018 Sep 18;4(4):479-483. (PMID: 30560180)
Knee Surg Sports Traumatol Arthrosc. 2016 Sep;24(9):2724-2728. (PMID: 25416672)
HSS J. 2011 Jul;7(2):183-6. (PMID: 22754420)
BMC Nephrol. 2012 Sep 03;13:101. (PMID: 22943390)
معلومات مُعتمدة: UL1 TR000117 United States TR NCATS NIH HHS; UL1 TR001998 United States TR NCATS NIH HHS
فهرسة مساهمة: Keywords: acute kidney injury; antibiotic prophylaxis; antibiotic stewardship; periprosthetic joint infection; race; total knee arthroplasty
المشرفين على المادة: 6Q205EH1VU (Vancomycin)
AYI8EX34EU (Creatinine)
تواريخ الأحداث: Date Created: 20190303 Date Completed: 20200428 Latest Revision: 20221207
رمز التحديث: 20231215
مُعرف محوري في PubMed: PMC6536310
DOI: 10.1016/j.arth.2019.01.058
PMID: 30824293
قاعدة البيانات: MEDLINE
الوصف
تدمد:1532-8406
DOI:10.1016/j.arth.2019.01.058