Chronic Kidney Diseases Among Patients Undergoing Elective Arthroplasty: Risk Groups and the Value of Serum Creatinine

J Arthroplasty. 2018 Jan;33(1):230-234.e1. doi: 10.1016/j.arth.2017.07.050. Epub 2017 Aug 9.

Abstract

Background: In arthroplasty clinics, we tend to evaluate patient's kidney function looking at serum creatinine (SCr), while estimated glomerular filtration rate (eGFR) is recommended. We reported the prevalence of chronic kidney disease (CKD; eGFR <60 mL/min/1.73 m2) in different patient groups and investigated whether CKD is missed by evaluation based on SCr.

Methods: Preoperative SCr values were used to calculate eGFR in 20,575 consecutive hip or knee arthroplasties.

Results: Prevalence of CKD was 9%-12%. It was higher among older women, knee arthroplasty patients, and patients with hypertension, diabetes, or coronary disease. Using SCr instead of eGFR leads to missing CKD in up to 7% of the cases. In older women and older patients with body mass index <25 kg/m2, half of CKD cases were missed.

Conclusion: Use of eGFR instead of SCr to detect CKD more accurately is recommended.

Keywords: arthroplasty; chronic kidney disease; estimated glomerular filtration rate; hip arthroplasty; knee arthroplasty; recognition.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Arthroplasty, Replacement, Hip*
  • Arthroplasty, Replacement, Knee*
  • Body Mass Index
  • Creatinine / blood
  • Elective Surgical Procedures
  • Female
  • Finland / epidemiology
  • Glomerular Filtration Rate
  • Humans
  • Hypertension
  • Male
  • Middle Aged
  • Prevalence
  • Renal Insufficiency, Chronic / blood
  • Renal Insufficiency, Chronic / epidemiology*
  • Risk Factors

Substances

  • Creatinine