International journal of medical sciences · 2026
New-onset renal diseases after total knee arthroplasty in patients with osteoarthritis: a multicenter retrospective cohort study.
СтатьяМногоцентровое исследованиеНазвание и аннотация: Перевод в очереди
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Chen Shiu-Jau, Lu Hsin-Yo, Wu Chih-Lung, Lin Chun-Wei, Chang Hui-Chin, Gau Shuo-Yan
Аннотация
BACKGROUND: Osteoarthritis (OA) is a debilitating condition often treated with total knee arthroplasty (TKA), a procedure effective in alleviating pain but associated with potential renal complications, including acute kidney injury (AKI) and chronic kidney disease (CKD). While perioperative risks are known, long-term kidney-related outcomes of TKA remain underexplored. This study investigates the association between TKA and the risks of new-onset AKI and CKD compared to non-surgical OA management.
METHOD: A retrospective cohort study using the TriNetX Research Network included adults with OA who underwent TKA (n=41,027) and matched non-surgical controls (n=41,027). Propensity score matching balanced demographics, comorbidities, and medical utilization. Renal outcomes were assessed using Hazard ratios (HRs) and 95% confidence intervals (CIs) were evaluated. Sensitivity and stratified analyses evaluated robustness and subgroup-specific risks.
RESULTS: TKA significantly increased the risk of AKI (HR: 1.48, 95% CI: 1.40-1.57) and CKD (HR: 1.30, 95% CI: 1.24-1.37). Females showed higher risks of AKI (HR: 1.55, 95% CI: 1.44-1.67) and CKD (HR: 1.32, 95% CI: 1.24-1.40). Younger patients (18-64 years) exhibited elevated risks of AKI (HR: 1.90, 95% CI: 1.56-2.31) and CKD (HR: 1.73, 95% CI: 1.38-2.18). Sensitivity analyses confirmed consistent results across various models.
CONCLUSION: TKA is associated with increased risks of AKI and CKD, particularly in females and younger patients. These findings underscore the need for enhanced perioperative care, renal risk stratification, and long-term monitoring to mitigate adverse renal outcomes in TKA recipients.
METHOD: A retrospective cohort study using the TriNetX Research Network included adults with OA who underwent TKA (n=41,027) and matched non-surgical controls (n=41,027). Propensity score matching balanced demographics, comorbidities, and medical utilization. Renal outcomes were assessed using Hazard ratios (HRs) and 95% confidence intervals (CIs) were evaluated. Sensitivity and stratified analyses evaluated robustness and subgroup-specific risks.
RESULTS: TKA significantly increased the risk of AKI (HR: 1.48, 95% CI: 1.40-1.57) and CKD (HR: 1.30, 95% CI: 1.24-1.37). Females showed higher risks of AKI (HR: 1.55, 95% CI: 1.44-1.67) and CKD (HR: 1.32, 95% CI: 1.24-1.40). Younger patients (18-64 years) exhibited elevated risks of AKI (HR: 1.90, 95% CI: 1.56-2.31) and CKD (HR: 1.73, 95% CI: 1.38-2.18). Sensitivity analyses confirmed consistent results across various models.
CONCLUSION: TKA is associated with increased risks of AKI and CKD, particularly in females and younger patients. These findings underscore the need for enhanced perioperative care, renal risk stratification, and long-term monitoring to mitigate adverse renal outcomes in TKA recipients.