Hip arthroplasty outcomes in the presence of kidney failure: a national data linkage study

Date

2023

Authors

Harris, I.A.
Lorimer, M.F.
Davies, C.E.
Keuskamp, D.
Dansie, K.
Lewis, P.
Graves, S.E.
McDonald, S.

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Journal article

Citation

Journal of Arthroplasty, 2023; 38(7):1295-1302

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Ian A. Harris, Michelle F. Lorimer, Christopher E. Davies, Dominic Keuskamp, Kathryn B. Dansie, Peter L. Lewis, Stephen E. Graves, Stephen P. McDonald

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Abstract

Background: Patients who have kidney failure are at higher risk of requiring total hip arthroplasty (THA) and are at higher risk of complications. This study compared the rate of revision surgery and mortality following THA between patients who have kidney failure receiving long term dialysis or who had a kidney transplant and those who did not have kidney failure. Methods: A data linkage study was performed using data from 2 national registries: a registry of dialysis and kidney transplant patients and a registry of THA procedures. Both registries had coverage of almost all procedures or treatments in Australia. Data from September 1999 to December 2016 were used. Mortality and revision surgery were compared between patients receiving dialysis, those who had a functioning kidney transplant, and patients who did not have kidney failure using Cox and Fine-Gray (competing risk) regression models. A total of 383,478 primary THA procedures were identified as people receiving dialysis (n ¼ 490), who had a functioning kidney transplant (n ¼ 459), or who did not have kidney failure (n ¼ 382,529). Results: There was no significant difference in the overall rate of revision surgery between the groups (dialysis versus no kidney failure HR ¼ 1.20; 95% CI 0.76, 1.88, transplant versus no kidney failure (hazard ratio) HR ¼ 1.01; 95% (confidence interval) CI 0.66, 1.53). The risk for death after surgery was significantly higher in the dialysis group compared to both the functioning transplant group (HR ¼ 3.44; 95%CI 1.58, 7.5), and in those without kidney failure (HR ¼ 4.13; 95%CI 3.25, 5.25).

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Available online 26 January 2023

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© 2023 Elsevier Inc. All rights reserved.

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