Impact of Neuraxial Versus General Anesthesia on Postoperative Acute Kidney Injury in Total Joint Arthroplasty

Abstract Purpose of Review This review summarizes current literature investigating the effect of neuraxial anesthesia versus general anesthesia on rates of postoperative acute kidney injury (AKI) in lower extremity joint arthroplasty. Recent Findings AKI can occur in 2–15% of patients following total hip arthroplasty (THA) and total knee arthroplasty (TKA), which can lead to significant morbidity, mortality, and increased readmissions and costs. Several large studies have consistently found a reduction in postoperative morbidity and healthcare costs when neuraxial anesthesia was used over general anesthesia in joint arthroplasty. Many of these studies also showed a lower odds ratio of AKI when neuraxial anesthesia was used. While the cause of acute kidney injury is often multifactorial, choice of anesthetic may influence odds of developing postoperative AKI. Summary Neuraxial anesthesia for lower extremity total joint arthroplasty may have lower rates of postoperative AKI compared to general anesthesia.