Association Between Chronic Kidney Disease and Blood Transfusions for Knee and Hip Arthroplasty Surgery

• Published in: The Journal of arthroplasty 2013-06, Vol.28 (6), p.928-931
• Main Authors: Augustin, Ian D., MD, Yeoh, Tze Yeng, MB, ChB, Sprung, Juraj, MD, PhD, Berry, Daniel J., MD, Schroeder, Darrell R., MS, Weingarten, Toby N., MD
• Format: Article
• Language: English
• Subjects: Aged; Arthroplasty, Replacement, Hip; Arthroplasty, Replacement, Knee; Blood Transfusion - statistics & numerical data; blood transfusions; Case-Control Studies; chronic kidney disease; Female; Hemoglobins - analysis; Humans; Male; Orthopedics; Renal Insufficiency, Chronic - blood; Renal Insufficiency, Chronic - complications; Retrospective Studies; total hip arthroplasty; total knee arthroplasty; uremic bleeding
• ISSN: 0883-5403; 1532-8406
• DOI: 10.1016/j.arth.2013.02.004

Abstract The study aim is to assess associations between chronic kidney disease (CKD) and blood transfusions during hospitalization for joint arthroplasty. Patients with Stage IV–V CKD who underwent elective total knee or hip arthroplasty from 2007 to 2010 were matched 2:1 with age, gender, and surgery type controls without kidney disease. Multivariable analyses for transfusion risk with preoperative hemoglobin, body mass index, cardiovascular disease, and surgical complexity as explanatory variables were performed. Ninety CKD patients were identified and had lower preoperative hemoglobin, higher incidence of cardiovascular disease and blood transfusions. CKD was independently associated with increased odds of transfusions (2.88, 95% confidence interval 1.33–6.23, P = 0.007). Preoperative optimization of CKD patients should be considered to reduce transfusion rates.