Lower stages of chronic kidney disease (CKD) do not affect outcomes after total hip or knee arthroplasty
Methods The outcomes of 779 patients who underwent THA or TKA between 2004 and 2011 (median 2.65 years follow-up) with evidence of CKD at surgery were retrospectively reviewed via an electronic medical record. Stages of CKD were categorized by the presence of proteinuria and two glomerular filtration rates separated by at least six months. Survival analysis was used to compare all-cause mortality, revision and infection among groups.
Results We compared 377 stage 1-2 CKD and 402 stage 3 CKD patients and observed no significant differences between the stages in terms of 90-day readmissions or revisions (p=0.67,0.38). Infections were marginally lower in stage 3 (p=0.05). For patients with stage 3 CKD, mortality rate after THA (16%) and overall mortality (9%) were significantly higher than mortality rate after THA (5%) and overall mortality (4%) in patients with stages 1-2 CKD (p=0.02).
Conclusion There is no increased risk of joint infection or revision in patients with stages 3 versus stage 1-2 CKD who undergo elective THA and TKA.
Learning Areas:Chronic disease management and prevention
Provision of health care to the public
Assess the risk of post-operative complications in patients with stages 1-3 chronic kidney disease who undergo elective hip or knee arthroplasty.
Keyword(s): Chronic Diseases, Risk Assessment
Qualified on the content I am responsible for because: I am the primary author on this retrospective review.
Any relevant financial relationships? No
I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.