Korean J Med.  2013 Jun;84(6):818-826.

Risk Factors and the Clinical Course of Acute Kidney Injury in Patients with a Femoral Fracture

• Yun YS
• Yu J
• Kim JH
• Kwon KW
• Lee HS
• Lee YB
• Bahk WJ
• Kim YO

Abstract

BACKGROUND/AIMS
Femoral fracture occurs most often in elderly patients and is highly associated with medical problems such as acute kidney injury (AKI); however no reports of AKI in femoral fracture patients have been published. This study was performed to identify risk factors and the clinical course of AKI in patients with femoral fracture.
METHODS
We retrospectively evaluated the medical records of 110 patients with femoral fracture between November 2006 and December 2011 at Uijeongbu St. Mary's Hospital. We investigated the incidence and clinical course of AKI in femoral fracture patients and compared the clinical findings between AKI and normal kidney function (NKF) groups.
RESULTS
Of the 110 femoral fracture patients, AKI was observed in 19 (17.3%). The peak serum creatinine level in patients with AKI was 2.59 +/- 1.57 mg/dL. Two of 19 patients with AKI died and two progressed to chronic kidney disease. When compared to the NKF group, the AKI group had a higher incidence of elevated lactate dehydrogenase (LDH) (63.2% vs. 34.1%, p = 0.020), erythrocyte sedimentation rate (ESR) (31.6% vs. 6.6%, p = 0.008), and C-reactive protein (57.9% vs. 46.2%, p = 0.042). The AKI group also had a longer hospitalization duration, and more patients were prescribed an angiotensin-converting-enzyme (ACE) inhibitor than in the NKF group. Multivariate analysis demonstrated elevated LDH, ESR and ACE inhibitor prescriptions as independent risk factors for AKI in patients with a femoral fracture.
CONCLUSIONS
The incidence of AKI in patients with a femoral fracture was 17.3%, and AKI was associated with a longer clinical course. We recommend monitoring of laboratory findings and medications and early management to reduce the morbidity of patients with AKI.

Keyword

Acute kidney injury; Femoral fractures; Risk factors

MeSH Terms

Acute Kidney Injury
Aged
Blood Sedimentation
C-Reactive Protein
Creatinine
Femoral Fractures
Hospitalization
Humans
Incidence
Kidney
L-Lactate Dehydrogenase
Medical Records
Multivariate Analysis
Prescriptions
Renal Insufficiency, Chronic
Retrospective Studies
Risk Factors
C-Reactive Protein
Creatinine
L-Lactate Dehydrogenase