Abstract 11358: Impact of Chronic Kidney Disease on Deep Vein Thrombosis after Total Hip and Total Knee Arthroplasty
Objectives: Previous reports have shown that chronic kidney disease (CKD) is associated with venous thromboembolism. While, patients undergoing major orthopedic surgery, which includes hip and knee arthroplasty, represent a group that is at particularly high risk for venous thromboembolism according to the 8th edition of the American College of Chest Physicians Evidence-Based Clinical Practice. However, few studies have examined the association between CKD and venous thromboembolism after orthopedic surgery. The aim of this study is to clarify the association between CKD and the incidence of deep vein thrombosis (DVT) after total hip arthroplasty (THA) and total knee arthroplasty (TKA).
Methods: From January 2008 to May 2010, consecutive 74 patients undergoing THA and TKA in our hospital were evaluated. All patients underwent doppler ultrasonography of the lower extremities before and after surgery. Postoperative doppler ultrasonographies were performed a mean of 8.0 ± 4.9 days after surgery. The patients with DVT before surgery were excluded. CKD was defined as estimated glomerular filtration rate less than 60ml/min/1.73m2.
Results: Of the 72 patients in our cohort, 15 patients developed DVT after operation (21%). The prevalence of CKD was 31% (22 patients). Patients with CKD showed a significant increase in the incidence of DVT compare with patients without CKD (41% vs. 12%, p < 0.05). Multiple logistic regression analysis revealed that CKD was associated with the incidence of DVT independent of age, gender, cardiovascular risk factors, and the use of anticoagulant drug as thromboprophylaxis (p < 0.05).
Conclusions: CKD was associated with the higher incidence of DVT after THA and TKA. Our results suggest that we may need more intensive management to avoid the development of DVT after THA and TKA in patients with CKD.
- © 2010 by American Heart Association, Inc.