Chronic kidney disease associated with perioperative transfusion in TJA
There was an association seen between stage 4 or stage 5 chronic kidney disease and the likelihood for additional perioperative blood transfusions in patients undergoing elective total joint arthroplasty in a recent study.
“Patients with chronic kidney disease undergoing major orthopedic surgery are at greater risk of requiring perioperative blood transfusions,” Ian D. Augustin, MD, and colleagues wrote. “This risk is independent of intraoperative estimated blood loss, preoperative anemia and higher rates of cardiovascular disease.”
Augustin and colleagues identified 90 cases of patients with chronic kidney disease (CKD) who underwent either unilateral total hip arthroplasty or unilateral total knee arthroplasty. Of those, 70 patients had the disease due to hypertension or diabetes mellitus, eight patients were on hemodialysis and 12 patients had previous kidney transplants but now had stage 4 or stage 5 CKD as of the time they underwent surgery.
The investigators found CKD was an independent risk factor for blood transfusion with a 4.52 odds ratio compared to control patients, according to the abstract. They reported no adverse events, but one patient in the control group had a postoperative myocardial infarction and later made a full recovery.
Disclosure: One of the authors (Berry) receives royalties and research support from DePuy Synthes.