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Prevalence and risk factors for perioperative complications of CKD patients undergoing elective hip surgery

Yongqing You1, Yijian Zhang2, Lei Qiang3,4

  • 1Department of Nephrology, Affiliated Hospital of Nanjing Medical University, North District of Suzhou Municipal Hospital, Suzhou, China. youyongiqngabc@163.com.

Journal of Orthopaedic Surgery and Research
|March 22, 2019
PubMed

Insights

Patients with chronic kidney disease (CKD) face higher risks of blood transfusions and ICU transfers after hip surgery. Addressing preoperative anemia is crucial for reducing transfusion rates in CKD patients undergoing orthopedic procedures.

Area of Science:

  • Nephrology
  • Orthopedic Surgery
  • Critical Care Medicine

Background:

  • Chronic kidney disease (CKD) is a significant risk factor for increased morbidity and mortality following orthopedic surgery.
  • Understanding the specific perioperative challenges faced by hip surgery patients with CKD is essential for improving outcomes.

Purpose of the Study:

  • To investigate the impact of chronic kidney disease (CKD) on perioperative complications in patients undergoing hip surgery.
  • To identify risk factors associated with adverse outcomes in this patient population.

Main Methods:

  • A cohort study involving 230 hip surgery patients (30 with CKD, 200 without) from 2013-2016.
  • Collection and analysis of preoperative, intraoperative, and postoperative data comparing CKD and non-CKD groups.
  • Logistic regression analysis to determine independent risk factors for postoperative complications.

Main Results:

  • CKD patients exhibited higher rates of preoperative comorbidities including hypertension, diabetes, coronary heart disease, and anemia.
  • CKD patients were significantly more likely to receive blood transfusions (50% vs 28.5%) and transfer to the ICU (73.3% vs 19.3%).
  • Independent risk factors for blood transfusion included diabetes, alcohol use, and anemia; factors for ICU transfer included age, CKD, and osteoporosis.

Conclusions:

  • Hip surgery patients with CKD present with more cardiac comorbidities preoperatively.
  • CKD is associated with an increased likelihood of requiring blood transfusions and ICU admission post-hip surgery.
  • Optimizing preoperative anemia in CKD patients may reduce the incidence of blood transfusions and associated complications.
Abstract

Keywords:
Chronic kidney diseaseComplicationsHip surgery

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