Predictors of postoperative acute kidney injury in patients undergoing hip fracture surgery: A systematic review and meta-analysis.

Abstract Background The present study aimed to summarize the predictors of acute kidney injury (AKI) in patients after hip surgery. Methods A literature search was performed using PubMed, EMBASE, Cochrane Library, and Web of Science for studies assessing the predictors of AKI after hip fracture surgery. Pooled odds ratio (OR) and mean difference (MD) of those who experienced AKI compared to those who did not were calculated for each variable. Evidence was assessed using the Newcastle–Ottawa Scale. Results Ten studies with 34 potential factors were included in the meta-analysis. In the primary analysis, 12 factors were associated with AKI, comprising males (OR 1.25; 95% confidence interval (CI) 1.14–1.36), advanced age (MD 2.28; 95% CI 0.80–3.75), myocardial infarction (OR 1.39; 95% CI 1.18–1.63), hypertension (OR 1.46; 95% CI 1.13–1.89), diabetes (OR 1.84; 95% CI 1.40–2.42), chronic kidney disease (OR 3.66; 95% CI 2.21–6.07), hip arthroplasty (OR 1.35; 95% CI 1.22–1.50), angiotensin-converting enzyme inhibitors/angiotensin receptor blockers use (OR 2.28; 95% CI 1.68–3.08), more intraoperative blood loss (MD 44.06; 95% CI 2.88–85.24), higher preoperative blood urea nitrogen levels (MD 5.29; 95% CI 3.38–7.20), higher preoperative serum creatinine levels (MD 0.4; 95% CI 0.26–0.53), and lower preoperative estimated glomerular filtration rate (MD −19.59; 95% CI −26.92–−12.26). Another 13 factors related to AKI in individual studies were identified in the systematic review. Conclusion Related prophylaxis strategies should be implemented in patients involved with the above-mentioned characteristics to prevent AKI after hip surgery.