The impact of chronic kidney disease and dialysis therapy on outcomes of elderly patients with hip fractures: A systematic review and meta-analysis

Abstract

Background and aimsHip fractures are a commonly occurring comorbidity in patients with chronic kidney disease. To evaluate the comparative rates of post-operative complications, revision surgery, and mortality after hip fracture surgery in chronic kidney disease patients undergoing hemodialysis.MethodsA systematic search of the academic literature was performed according to the PRISMA guidelines across five databases: Web of Science, EMBASE, CENTRAL, Scopus, and MEDLINE. A random-effect meta-analysis was conducted to evaluate the overall comparative risks of post-operative complications in chronic kidney disease patients.ResultsOut of 993 studies, 11 eligible studies were included in the review, with a total of 72618 chronic kidney disease patients (mean age: 75.3  ±  3.0 years), and 50566 healthy controls (75.3  ±  2.6 years). Meta-analysis revealed a higher risk of post-operative complications (Odd's ratio: 1.76), revision surgeries (1.69), and mortality-related outcomes (2.47) after hip fracture surgery in chronic kidney disease patients undergoing hemodialysis as compared to chronic kidney disease patients not undergoing hemodialysis.ConclusionWe report higher risks of post-operative complications, revision surgery, and mortality in chronic kidney disease patients undergoing hemodialysis as compared to chronic kidney disease patients not undergoing hemodialysis.