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Diastolic dysfunction and acute kidney injury in elderly patients with femoral neck fracture

Authors
Cho W.Hwang T.Y.Choi Y.K.Yang J.H.Kim M.-G.Jo S.-K.Cho W.Y.Oh S.W.
Issue Date
2019
Publisher
The Korean Society of Nephrology
Keywords
Acute kidney injury; Diastolic heart failure; Femoral neck fractures
Citation
Kidney Research and Clinical Practice, v.38, no.1, pp.33 - 41
Indexed
SCOPUS
KCI
Journal Title
Kidney Research and Clinical Practice
Volume
38
Number
1
Start Page
33
End Page
41
URI
https://scholarworks.korea.ac.kr/kumedicine/handle/2020.sw.kumedicine/2736
DOI
10.23876/j.krcp.18.0083
ISSN
2211-9132
Abstract
Background: Femoral neck fracture is common in the elderly population. Acute kidney injury (AKI) is an important risk factor for mortality in patients who have had such fracture. We evaluated the incidence of AKI in patients who had femoral neck fracture and identified risk factors for AKI and mortality. Methods: This was an observational cohort study including 285 patients who were ≥ 65 years of age and who underwent femoral neck fracture surgery between 2013 and 2017. Results: The mean age was 78.63 ± 6.75 years. A total of 67 (23.5%) patients developed AKI during the hospital stay: 57 (85.1%), 5 (7.5%), and 5 (7.5%) patients were classified as having stage 1, 2, and 3 AKI, respectively. Patients with AKI had a lower baseline estimated glomerular filtration rate and higher left atrial dimension, left ventricular mass index, pulmonary artery pressure, and the ratio of early mitral inflow velocity to early diastolic mitral annulus velocity (E/e’) and were more likely to have diabetes or hypertension (HTN) (P < 0.05). The presence of HTN (odds ratio [OR], 4.570; 95% confidence interval [CI], 1.632-12.797) higher E/e’ (OR, 1.105; 95% CI, 1.019-1.198), and lower hemoglobin (OR, 0.704; 95% CI, 0.528-0.938) were independently associated with a higher risk for developing AKI. Severe AKI (OR, 24.743; 95% CI, 2.822-212.401) was associated with a higher risk of mortality. Conclusion: Elderly patients with femoral neck fracture had a high incidence of AKI. Diastolic dysfunction was associated with AKI. Severe AKI was associated with in-hospital mortality. © 2019 by The Korean Society of Nephrology.
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Anam Hospital (Department of Nephrology and Hypertension, Anam Hospital)
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