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Title of Journal: Arch Orthop Trauma Surg

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Abbravation: Archives of Orthopaedic and Trauma Surgery

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Springer Berlin Heidelberg

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DOI

10.1016/0168-9002(85)90027-0

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ISSN

1434-3916

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The effect of renal function on surgical outcomes

Authors: LiangTseng Kuo SuJu Lin WeiHsiu Hsu KuoTi Peng ChunLiang Lin Robert WenWei Hsu
Publish Date: 2013/11/21
Volume: 134, Issue: 1, Pages: 39-45
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Abstract

Chronic kidney disease CKD affects many physiologic systems including bone quality nutrition and cardiovascular condition Femoral neck fractures in patients on dialysis are associated with frequent complications and a high risk of mortality However the effect of CKD on clinical outcomes of patients with hip fractures treated with osteosynthesis remains unclearOne hundred and thirty patients with 130 femoral neck fractures treated with internal fixation were divided into two groups and the data were then analyzed Group 1 consisted of 98 patients 98 hip fractures with normal renal function estimated glomerular filtration rate or eGFR ≥60 ml/min/173 m2 Group 2 was composed of 32 patients 32 hip fractures with CKD eGFR 60 ml/min/173 m2 without dialysis Clinical outcomes as well as early and late complications were recorded for each group Survivorship analysis was performed and the mortality and complication rates for the groups were then comparedIn Group 1 32 complications 326  occurred in 98 hips including 5 cases of nonunion and 16 cases of osteonecrosis In Group 2 24 complications 75  developed in 32 hips these included 8 cases of nonunion and 3 cases of osteonecrosis The mean duration of followup was 32 months The overall mortality rate was 115  No difference was noted in early late or overall mortality rate between two groups Patient with CKD had a higher nonunion rate OR = 59 P = 0023 Meanwhile CKD and displaced fracture pattern were independent predictors for revision surgery OR = 30 P = 0032 OR = 69 P = 0001 respectively

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