ArticleArchives of orthopaedic and trauma surgery2021
End-stage renal disease increases risk of postoperative complications after lower extremity fracture.
Article in Archives of orthopaedic and trauma surgery, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
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Who cites it
4 citing papers in PubMed, 7 citations in OpenAlex.
- Outcomes after surgical fixation of lower extremity fractures in patients with chronic kidney disease.OTA international : the open access journal of orthopaedic trauma · 2026Article
- Orthopaedic fracture site and wound healing risk among end-stage renal disease patients undergoing open reduction internal fixation: A database analysis.Journal of clinical orthopaedics and trauma · 2025Article
- Fracture Management in Chronic Kidney Disease: Challenges and Considerations for Orthopedic Surgeons.Clinics in orthopedic surgery · 2024Review
- Renal disease is a risk factor for complications and mortality after open reduction internal fixation of proximal humerus fractures.JSES international · 2022Article
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Authors and funding
5 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionEnd-stage renal disease (ESRD) leads to multiple systemic effects and patients suffer from multiple comorbidities including fractures. While previous studies have examined complications following hip fracture surgery in ESRD patients, there are no studies evaluating other lower extremity fractures. This study aimed to identify postoperative complication risk in patients with ESRD who had lower extremity fractures.
methodsUsing our database from 2000 to 2015 at two level-one trauma centres, we collected data on patients over age 40, who had lower extremity fractures and surgical fixation. Diagnosis of ESRD was made before the injury. Each ESRD patient was matched by two non-ESRD patients regarding age, gender, American Society of Anaesthesiologists (ASA) score, and AO/OTA fracture classification. Postoperative outcomes were non-union, mechanical failure, and infection. The number of outcome events was compared between the ESRD and non-ESRD cohorts.
resultsA total of 195 patients (65 ESRD patients matched to 130 non-ESRD patients) were identified. Median follow-up was 31 months (12-141 months). Patients with ESRD were 3.6 time more likely to have at least one postoperative complication (mechanical failure, non-union, or infection) compared to non-ESRD patients (9/65 vs. 5/130, p = 0.02). In particular, mechanical failure was eight times higher among ESRD patients compared to non-ESRD patients (8/65 vs. 2/130, p < 0.01).
conclusionsESRD was associated with higher rates of complications, especially mechanical failure, after lower extremity fracture surgeries.
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