Influence of Chronic Kidney Disease on Patients Undergoing Elective Hip and Knee Orthopedic Surgery: A Systematic Review and Meta-Analysis

Zhang, Yijian; Shao, Yijie; Líu, Hao; He, Fan; Bou, Emily Hong; Yang, Huilin; Pi, Bin

doi:10.1080/08941939.2019.1631412

Cited by 2 publications

(5 citation statements)

References 47 publications

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“… 48 For CKD patients with diabetes, establishing individualized glycaemic targets to maintain normal blood glucose levels during the perioperative period is of great significance. The risk of hypoglycaemia in patients with diabetic nephropathy (DN) increased when the GFR was <60 mL/min·1.73 m, 2 mainly caused by decreased clearance of hypoglycaemic drugs and downregulation of renal gluconeogenesis. 49 Therefore, choosing of hypoglycaemic drugs requires carefully weighing the risks and benefits for CKD patients.…”

Section: Discussionmentioning

confidence: 99%

“…Age, male sex, and complications were all independent predictors of postoperative creatinine elevation in CKD patients 1 . Studies have indicated, that compared with non‐CKD patients, CKD patients showed worse health conditions and had higher rates of comorbidities and complications in the perioperative period of joint arthroplasty 2,3 . In addition, there have been studies showing that CKD/end‐stage renal disease (ESRD) patients had a greater risk of postoperative surgical site infections and wound complications than non‐CKD patients, especially CKD/ESRD patients receiving dialysis therapy 4 .…”

Section: Introductionmentioning

confidence: 99%

“…1 Studies have indicated, that compared with non-CKD patients, CKD patients showed worse health conditions and had higher rates of comorbidities and complications in the perioperative period of joint arthroplasty. 2,3 In addition, there have been studies showing that CKD/end-stage renal disease (ESRD) patients had a greater risk of postoperative surgical site infections and wound complications than non-CKD patients, especially CKD/ESRD patients receiving dialysis therapy. 4 All of these findings emphasize the importance of perioperative management strategies for CKD patients after joint arthroplasty.…”

Section: Introductionmentioning

confidence: 99%

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A Retrospective Study of the Perioperative Period Management of Joint Arthroplasty in Patients with Chronic Kidney Disease

Jin

Yang

et al. 2022

Orthopaedic Surgery

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Objective With the rising prevalence of chronic kidney disease (CKD) and the increasing demand for joint arthroplasty, the management of CKD patients in the perioperative period of joint arthroplasty has become an issue worthy of attention for orthopedic surgeons. This study aimed to explore comprehensive perioperative period management strategies for CKD patients. Methods From March 2017 to August 2022, 62 patients who underwent joint arthroplasty in our hospital were included in a retrospective study, including 31 CKD patients (mean age 69.8 ± 13.4 years old) and 31 non‐CKD patients (mean age 69.4 ± 14.2 years old). The outcome indicators were analyzed, including serum urea, serum creatinine, blood uric acid, hematocrit, and hemoglobin. Results All patients included in the retrospective study had an average preoperative preparation time of 4.3 ± 2.6 days and an average hospitalization time of 11.0 ± 7.3 days. There were no significant differences in the changes in the serum urea values between the preoperative and postoperative measurements in the CKD patients or in the serum creatinine values and blood uric acid values (P > 0.05). The hemoglobin value in postoperative measurements was lower than in preoperative measurements in the CKD patients (P < 0.05). The hematocrit value in postoperative measurements was lower than in preoperative measurements in the CKD patients (P < 0.001). Conclusion Patients with CKD have distinct characteristics compared to non‐CKD patients, and they generally have a higher risk for postoperative complications and adverse events. Recognition of risk factors, suitable timing of surgery, the undertaking of protective strategies, and proper management of complications are vital for managing CKD patients in the perioperative period of joint arthroplasty.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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A Retrospective Study of the Perioperative Period Management of Joint Arthroplasty in Patients with Chronic Kidney Disease

Jin

Yang

et al. 2022

Orthopaedic Surgery

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“…A clear example can be found in the revision of arthroplasties related to kidney problems [4], where there are coherent results that may put us to think. The presence of kidney diseases means more complications during the surgery, therefore, more risks for the patient [4]. Despite that, we are still taking the risk.…”

mentioning

confidence: 99%

“…The main problem persists in the patients with chronic diseases which deteriorates their quality of life; and during the surgery, when, we know, many problems not related to those patients can also appear [1,2,4].…”

mentioning

confidence: 99%