Incidence, Severity and Reversibility of Acute Kidney Injury after Elective Hip and Knee Arthroplasty in Patients Receiving Celecoxib Perioperatively as One of the Standard Multimodal Analgesic Protocols

Abstract

Background: Acute Kidney Injury (AKI) may complicate up to 10% of primary lower-extremity total joint arthroplasties. However, none of these previous studies evaluated the duration and reversibility of AKI. Moreover, none specifically evaluated the impact of perioperative celecoxib on the incidence and severity of AKI, especially for patients with preexisting renal impairment. This study was to retrospectively review the incidence, severity and duration of AKI with short term perioperative celecoxib. We also aimed to evaluate the impact of perioperative celecoxib on the incidence and severity of AKI in patients with and without preexisting renal impairment. Methods: We retrospectively reviewed 1077 patients at Queen Mary Hospital, Hong Kong, from January 2018 to December 2021. Data were retrieved from the computerized medical records system. Results: One hundred of 1077 patients (9.3%) had postoperative AKI. Eight hundred eighty-eight patients (82.5%) were prescribed perioperative celecoxib, while 189 patients (17.5%) were not. The overall incidence of AKI in those taking perioperative celecoxib was 9.2%, while it was 9.5% in those not taking perioperative celecoxib. There was no statistically significant difference. There was no association between perioperative celecoxib and postoperative AKI. Among those who received perioperative celecoxib, the overall incidence of postoperative AKI in those with and without preexisting renal impairment (normal renal function test) was 9.3% and 9.2%, respectively. This was not statistically significant. The duration of AKI was 4 days for both groups. In both groups, most AKI cases were stage 1. Conclusions: Short term perioperative celecoxib probably had no additional AKI risk even in patients with preexisting renal impairment.