transplantation is a risk factor for acute kidney injury in patients undergoing total hip replacement arthroplasty for avascular necrosis an observational study background the increased number of patients undergoing transplantation has increased the number of transplant recipients undergoing total hip replacement arthroplasty thra we have evaluated the association between transplantation and acute kidney injury aki in patients undergoing thramethods patients who underwent thra from may 2004 to february 2012 were retrospectively assessed their demographic and clinical characteristics the results of perioperative laboratory tests the amounts of fluids transfused during surgery and anesthesia time were evaluated patients were divided into 2 groups transplant n 222 and nontransplant n 2044 patients with use of the maximal acute kidney injury network criteria aki was evaluated by changes in creatinine concentration within 48 hours of thra propensity analyses and logistic regression were performed to evaluate the association between transplantation and postoperative akiresults postoperative aki was significantly associated with transplantation p 0001 and transplantation was an independent factor predictive of postoperative aki p 0001conclusions transplant recipients are at risk for aki following thra the mechanism by which organ transplantation enhances postoperative aki warrants further evaluation