Effect of chronic kidney disease on complications and mortality after fracture surgery

Abstract

Purpose The purpose of this meta-analysis was to evaluate the effect of CKD on postoperative complications and survival of fractures. Methods The PubMed, Embase, Cochrane Library and CNKI databases were searched from inception to May 15, 2024. The search strategy focused on two keywords: dialysis and hip fracture. Pooled odds ratios and mean differences were analyzed. RevMan 5.4 was used for data analysis in this meta-analysis. Results This meta-analysis included 19 studies involving 1,615,440 patients. The CKD group had higher proportions of males, smokers, and preoperative comorbidities such as diabetes, hypertension, heart failure, chronic lung disease, coronary heart disease, peripheral vascular disease, dementia, and wound infection. The CKD group also had a higher likelihood of postoperative myocardial infarction (OR = 1.67, 95% CI = 1.54 to 1.81, P < 0.00001). There was no significant difference in cerebrovascular accidents, liver failure, sepsis, and overall complications between the two groups. Additionally, the CKD group had higher mortality rates at 30 days (OR = 2.71, 95% CI = 2.23 to 3.28, P < 0.00001), 1 year (OR = 3.17, 95% CI = 2.64 to 3.82, P < 0.00001), 2 years (OR = 3.06, 95% CI = 2.88 to 3.25, P < 0.00001), and 10 years (OR = 6.85, 95% CI = 5.84 to 8.03, P < 0.00001) post-surgery compared to the non-CKD group. Conclusion Compared to the non-CKD group, patients in the CKD group did not show a significant difference in the incidence of postoperative complications after fracture surgery, but their postoperative mortality rate was significantly higher.