With the projected increase in joint replacement in the next few decades, along with the increased prevalence of renal insufficiency, arthroplasty surgeons must have a good understanding of the routine management of renal impairment in the perioperative setting. Multiple studies have demonstrated significant effect on arthroplasty outcomes, morbidity, and mortality. We highlight several key strategies in the perioperative management of both acute and chronic renal insufficiency. A multidisciplinary approach should be pursued in the perioperative management of renal disease, with important considerations for cardiovascular, hematopoietic, anesthetic, and infection prevention.
Department of Orthopedic Surgery, Columbia University Medical Center, New York Presbyterian Hospital, New York, NY
This project was supported by an unrestricted grant from KCI, an Acelity company. Project management support was provided by MedicusWorks.
J.A.G. receives research support from the Orthopaedic Scientific Research Foundation, OrthoSensor, and Smith & Nephew. He is also a paid consultant for Smith & Nephew. The remaining authors declare that they have nothing to disclose.
For reprint requests, or additional information and guidance on the techniques described in the article, please contact Jeffrey A. Geller, MD, at or by mail at Department of Orthopedic Surgery, Columbia University Medical Center, 622 West 168th Street, PH 1138, New York, NY 10032. You may inquire whether the author(s) will agree to phone conferences and/or visits regarding these techniques.