Impact of Chronic Kidney Disease in Older Adults Undergoing Hip or Knee Arthroplasty: A Large Database Study

Antoniak, Derrick; Benes, Brian J.; Hartman, Curtis W.; Vokoun, Chad; Samson, Kaeli; Shiffermiller, Jason

doi:10.1016/j.arth.2019.12.040

Cited by 9 publications

(4 citation statements)

References 36 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Thus, using eGFR to readily assess the severity of CKD allows for a more discrete assessment of preoperative and postoperative risk, rather than using the presence or absence of comorbid conditions. 20,24 In our study, using eGFR as marker for impaired renal function, we found that pre-dialysis CKD patients and ESRD patients on dialysis have increased odds of postoperative complications when compared to patients with no kidney disease regardless of type of surgical intervention. Our study demonstrated that even those with pre-dialysis CKD are at significant increased risk for multiple organ system complications in the immediate 30-day postoperative period, indicating the need for a multidisciplinary approach to perioperative care.…”

Section: Discussionmentioning

confidence: 64%

“…Antoniak et al 24 note that early CKD can be under-recognised. Thus, using eGFR to readily assess the severity of CKD allows for a more discrete assessment of preoperative and postoperative risk, rather than using the presence or absence of comorbid conditions.…”

Section: Discussionmentioning

confidence: 99%

“…7 With subsequent secondary hyperparathyroidism, preferential periosteal resorption of cortical bone occurs, leading to the formation of osteitis fibrosa, decreasing cortical strength in areas that are rich such as the femoral neck. 7,8 Antoniak et al 24 note that early CKD can be under-recognised. Thus, using eGFR to readily assess the severity of CKD allows for a more discrete assessment of preoperative and postoperative risk, rather than using the presence or absence of comorbid conditions.…”

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Impaired renal function is an independent risk factor for complications after surgery for femoral neck fracture

Ramamurti¹,

Fassihi²,

Sacolick³

et al. 2021

HIP International

View full text Add to dashboard Cite

Background: The metabolic abnormalities that occur secondary to chronic kidney disease (CKD) increase the risk of femoral neck fractures compared to the general population. The purpose of this study is to determine whether impaired renal function is an independent risk factor for complications after surgery for femoral neck fracture. Methods: The ACS-NSQIP database was reviewed for patients who underwent total hip arthroplasty, hemiarthroplasty and open reduction internal fixation (ORIF) for femoral neck fractures between 2007 and 2018. Patients were split into cohorts based on calculated estimated glomerular filtration rate. Demographic information, comorbidities, and 30-day complications were analysed with univariate and multivariate analyses using chi-square, Fischer’s exact and analysis of variance testing. Results: The total number of patients for the study was 163,717. Patients with CKD stage 4 and 5 had an increased rate of any complication (39.1 and 36.7% respectively) compared with higher eGFRs ( p < 0.001). Similarly, 30-day mortality was increased at 6.0% and 6.7% for both stage 4 and 5 ( p < 0.001). By multivariate regression, those with CKD Stage 4 and 5 were at increased risk for any complication compared to patients with a normal preoperative eGFR of 90–120 ( p < 0.001). Conclusions: This study demonstrated that patients with CKD Stage 4 and 5 are at increased risks of all complications, including death, renal, pulmonary and thromboembolic disease. Therefore, these patients should be cared for from a multidisciplinary approach with close attention to postoperative medications and fall prevention to help mitigate the risk of complications in the immediate postoperative period.

show abstract

Section: Discussionmentioning

confidence: 64%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Impaired renal function is an independent risk factor for complications after surgery for femoral neck fracture

Ramamurti¹,

Fassihi²,

Sacolick³

et al. 2021

HIP International

View full text Add to dashboard Cite

show abstract

“…Antonia et al . [ 5 ] suggested stage III and IV CKD were associated with the major postoperative complications. Currently, no meta-analysis elucidated the outcomes of TKA in CKD patients.…”

Section: Introductionmentioning

confidence: 99%

Effect of chronic kidney disease on total knee arthroplasty outcomes: a meta-analysis of matched control studies

et al. 2021

View full text Add to dashboard Cite

Purpose The purpose of this meta-analysis was to review the current evidence in the literature to find out whether the coexisting chronic kidney disease affected infection, revision, transfusion, readmission, mortality, and the length of hospital stay after total knee arthroplasty. Methods Medline, PubMed, Embase, and the Cochrane Library were searched from their dates of inception to June 30, 2020. The primary outcomes were postoperative infection, revision, and mortality. The secondary outcomes were transfusion, the length of hospital stay, and readmission. A P value of < 0.05 was deemed to be statistically significant. Results A total of 881 articles were identified, and 7 articles that met the inclusion criteria were identified to be eligible. The most important finding of our study was that the chronic kidney disease was associated with increased postoperative transfusion (P < 0.05) and mortality (P < 0.05). Meanwhile, the patients with chronic kidney disease were associated with a higher readmission rate, compared to the patients without chronic kidney disease (P < 0.05). However, chronic kidney disease was not associated with high risks for infection (P > 0.05), revision surgeries (P > 0.05), and a prolonged hospital stay (P > 0.05). Conclusions After total knee arthroplasty, the patients with coexisting chronic kidney disease carry higher risks of transfusion, mortality, and readmission. However, the chronic kidney disease may not be associated with the risk of infection or revision, nor the duration of hospitalization.

show abstract

Total hip arthroplasty complications in patients with chronic kidney disease: A comparison study

Fox

Domingue

DeMaio

et al. 2023

Journal of Orthopaedics

View full text Add to dashboard Cite

Impact of Chronic Kidney Disease in Older Adults Undergoing Hip or Knee Arthroplasty: A Large Database Study

Cited by 9 publications

References 36 publications

Impaired renal function is an independent risk factor for complications after surgery for femoral neck fracture

Impaired renal function is an independent risk factor for complications after surgery for femoral neck fracture

Effect of chronic kidney disease on total knee arthroplasty outcomes: a meta-analysis of matched control studies

Total hip arthroplasty complications in patients with chronic kidney disease: A comparison study

Contact Info

Product

Resources

About