Can Total Joint Arthroplasty Be Safely Performed in Patients with Chronic Kidney Disease?

Patients suffering from chronic kidney disease are at greater risk of perioperative and postoperative complications. There is no systematic review study demonstrating whether total joint arthroplasty can be safely performed in patients with chronic kidney disease.

A literature search was performed in the PubMed, Embase, Web of Science, China National Knowledge Infrastructure, Wanfang, and Cochrane Library databases for information from the earliest date of data collection to September of 2018. Studies comparing the perioperative and postoperative outcomes of no-chronic kidney dysfunction (CKD) patients with those of CKD patients were included. Statistical heterogeneity was quantitatively evaluated by means of the χ2 test, with significance set at P < .10 or I2 > 50%.

Three articles consisting of 38,209 patients were included (35,363 no-CKD patients and 2,846 CKD patients). The results showed that CKD was related to a greater increase in postoperative infection rate, deep vein thrombosis, readmission, and mortality (P < .1). No differences in length of surgery, length of stay, pulmonary embolism, or revision were observed (P > .10).

Compared with no-CKD patients, CKD patients demonstrated an increased risk of perioperative and postoperative complications.