Total Joint Arthroplasty in Patients with Chronic Renal Disease: Is It Worth the Risk?

Lucian C. Warth, Andrew J. Pugely, Christopher T. Martin, Yubo Gao, John J. Callaghan

Research output: Contribution to journalArticlepeer-review

26 Scopus citations

Abstract

26-27% of patients with end stage hip and knee arthritis requiring TJR have chronic renal disease. A multi-center, prospective clinical registry was queried for TJA's from 2006 to 2012, and 74,300 cases were analyzed. Renal impairment was quantified using estimated glomerular filtration rate (eGFR) to stratify each patient by stage of CRD (1-5). There was a significantly greater rate of overall complications in patients with moderate to severe CRD (6.1% vs. 7.6%, P < 0.001). In those with CRD (Stage 3-5), mortality was twice as high (0.26% vs. 0.48%, P < 0.001). Patients with Stage 4 and 5 CRD had a 213% increased risk of any complication (OR 2.13, 95% CI: 1.73-2.62). Surgeons may use these findings to discuss the risk-benefit ratio of elective TJR in patients with CRD.

Original languageEnglish (US)
Pages (from-to)51-54
Number of pages4
JournalJournal of Arthroplasty
Volume30
Issue number9
DOIs
StatePublished - Sep 1 2015

Bibliographical note

Publisher Copyright:
© 2015 Elsevier Inc..

Copyright:
Copyright 2016 Elsevier B.V., All rights reserved.

Keywords

  • ACS NSQIP
  • Chronic renal disease
  • Database
  • EGFR (estimated glomerular filtration rate)
  • Total joint arthroplasty

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