Incidental Finding of Deranged Renal Function in Elderly Patients Presenting with Fractures in a Tertiary Care Hospital

Abstract

Objective: To determine the incidental rate of renal impairment among elderly women with fractures who reported to the Orthopaedic OPD at a tertiary care Hospital. Methodology: This prospective cohort study was done at Orthopaedic department and OPD Fauji Foundation Hospital, Rawalpindi during a period of one year from March 2022 to February 2023. A total of 147 females aged >60 years presented with Hip fractures, surgically managed and who had history of normal pre-fracture renal function were included. A 5ml blood sample was obtained and sent to the Hospital diagnostic laboratory to evaluate the renal profile, serum calcium and vitamin D levels. All the information was recorded via pre-structured study proforma.  Results: The study enrolled 147 elderly participants with an average age of 66.82 years. Among the participants, 24 patients (16.3%) experienced Acute Kidney Injury (AKI), with 9.5% having stage-I AKI, 4.8% with stage II AKI, and 2.0% with stage III AKI. Before sustaining the hip fracture, the mean serum creatinine level was 67.04 µmol/L, and following the fracture, it increased to 81.95 µmol/L (p-value < 0.0001). The severity of AKI did not exhibit a statistically significant correlation with the age of the patients. However, there was a statistically significant increase in serum creatinine levels among patients based on the duration of their fractures (p-value < 0.001). Conclusion: The incidence of Acute Kidney Injury (AKI) in elderly patients following hip fractures was found to be 16.3%, with varying stages of severity.