Shin KH, et al. - Researchers determined the incidence of and risk factors for acute kidney injury (AKI) and the effects of early postoperative hypoalbuminemia on AKI incidence after surgery for hip fractures, especially intertrochanteric fractures of the proximal femur. Postoperative AKI incidence of 11.8% was observed. Findings demonstrated early postoperative hypoalbuminemia to be an independent risk factor for AKI in patients undergoing surgery for intertrochanteric fracture of the proximal femur.

Methods

• Researchers performed a retrospective cohort study from a single center.
• The medical records of 481 consecutive patients ( > 60 years) who underwent surgery for intertrochanteric fracture of the proximal femur were reviewed. Independent risk factors for AKI were assessed via performing multiple logistic regression.
• Based on the cut-off value of the minimal level of postoperative serum albumin determined during the first two postoperative days, the patients were divided into two groups: group 1 included 251 patients whose minimal early postoperative serum albumin level was <2.9 g/dL during the first two postoperative days; and group 2 included 230 patients whose minimal early postoperative serum albumin level was ≥2.9 g/dL.
• They used inverse probability of treatment weighting (IPTW), propensity score matching (PSM), and propensity score matching weighting (PSMW) analyses to analyze the incidence of AKI.
• As per the Kidney Disease Improving Global Outcomes criteria, AKI was defined.

Results

• The incidence of AKI was 11.8% (n = 57).
• Independent risk factors for AKI included chronic kidney disease and the minimal early postoperative serum albumin level <2.9 g/dL at any point during the first two postoperative days.
• Comparison of the two groups, via IPTW, PSM, and PSMW analyses, regarding the incidence of AKI demonstrated that the minimal early postoperative serum albumin level <2.9 g/dL was significantly associated with AKI development (P < 0.001, P=0.025, and P=0.011, respectively).