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

PURPOSE: Chronic kidney disease (CKD) is known to increase morbidity and mortality after orthopedic surgery. The purpose of this study is to investigate how CKD affects perioperative complications in hip surgery patients. MATERIAL AND METHODS: From 2013 to 2016, a total of 230 patients (30 patients with CKD and 200 without CKD) undergoing hip surgery were enrolled in this study. Preoperative, intraoperative, and postoperative data was collected and analyzed between CKD and non-CKD patients. Logistic regression was used to evaluate the independent risk factor for postoperative complications. RESULTS: There were significant differences in the number of people with hypertension (90.0% vs 27.3%, P < 0.001), diabetes (33.3% vs 8.7%, P = 0.01), coronary heart disease (20.0% vs 2.0%, P = 0.001), smoking habits (56.7% vs 22.7%, P = 0.016), anemia (90.0% vs 19.3%, P < 0.001), and low hemoglobin levels (94.1 ± 19.7 vs 121.3 ± 18.8, P < 0.001) between CKD and non-CKD patients before surgery. Receiving a blood transfusion was significantly more common in CKD patients (50% vs 28.5%, P = 0.018). Postoperatively, significant differences were detected in the average number of patients who transferred to the ICU (73.3% vs 19.3%, P < 0.001). Furthermore, differences were found in the quantity of hemoglobin (92.5 ± 16.8 vs 107.5 ± 18.3, P < 0.001) and albumin (32.4 ± 4.1 vs 34.9 ± 5.5, P = 0.02) measured between CKD and non-CKD patients. Logistic regression analysis indicated that diabetes, alcohol, and anemia were all independent risk factors for obtaining a blood transfusion, while age, CKD, and osteoporosis were all independent risk factors for ICU transfers. CONCLUSION: Compared with non-CKD patients, CKD patients were accompanied with more cardiac diseases preoperatively. In addition, CKD patients were more likely to receive a blood transfusion and transfer to the ICU after hip surgery. Preoperative anemia should be restored sufficiently to decrease the incidence of blood transfusions.