In the postoperative phase, NSAIDs have been found to be particularly effective analgesic medications. NSAIDs have a number of possible side effects, including acute kidney injury (AKI). In the outpatient total joint arthroplasty (TJA) environment, little is known regarding AKI when patient labs are not regularly maintained. For a study, researchers sought to assess the renal safety of using ibuprofen for pain relief and aspirin for deep vein thrombosis chemoprophylaxis following outpatient primary TJA.
Patients receiving total primary hip or total knee arthroplasty at a single facility between January 2020 and July 2020 were included in the study. All patients involved in the study were released on a routine prescription of aspirin 81 mg twice daily and ibuprofen 600 mg thrice daily. A blood creatinine test was ordered for each patient two and four weeks after surgery. Acute Renal Damage Network criteria were used to identify patients with postoperative acute kidney injury.
The study comprised 113 patients between January 23, 2020, and August 30, 2020, with creatinine levels assessed in 103 patients (90.3%) at the 2-week postoperative time point, 58 patients (50.9%) at the 4-week time point, and 48 (42.1%) at the combined 2- and 4-week time points. AKI was discovered in three individuals (2.9%).
This study discovered a rate of AKI of 2.9% when dual NSAID treatment was used postoperatively after initial TJA. All instances occurred at 2 weeks postoperatively and resolved spontaneously.
Reference: journals.lww.com/jaaos/Abstract/2022/07150/Postoperative_Acute_Kidney_Injury_With_Dual_NSAID.6.aspx
