The Impact of Chronic Kidney Disease on Postoperative Outcomes in Patients Undergoing Lumbar Decompression and Fusion.

Published

Journal Article

OBJECTIVE: To determine whether preoperative chronic kidney disease (CKD) is associated with inferior perioperative outcomes in patients undergoing lumbar arthrodesis. METHODS: Medical records of 293 adult (≥18 years old) patients with spine deformity undergoing elective lumbar spine decompression and fusion at a major academic institution from 2006 to 2015 were reviewed. We identified 18 (6.1%) patients with a clinical diagnosis of CKD (CKD group, n = 18; no-CKD group, n = 275). Patient demographics, comorbidities, and intraoperative and postoperative complication rates were collected for each patient. The primary endpoint was incidence of postoperative complications. RESULTS: Patient demographics, including age, sex, and body mass index, and comorbidities were similar between cohorts. The CKD group had a significantly higher prevalence of hypertension, hyperlipidemia, and anemia compared with the no-CKD group. Median number of fusion levels, length of surgery, and estimated blood loss were similar between both cohorts. Postoperative complication profile was significantly different between the cohorts, with the CKD group having a significantly higher proportion of patients transferred to the intensive care unit (52.9% vs. 29.3%, P = 0.04) with episodes of delirium (27.8% vs. 8.4%, P = 0.007), urinary tract infection (27.8% vs. 6.9%, P = 0.0002), and deep vein thrombosis (5.6% vs. 0.4%, P = 0.01). Although not significant, the CKD group had a 2-fold higher rate of 30-day readmissions compared with the no-CKD group (CKD group: 27.8% vs. no-CKD group: 12.7%, P = 0.07). CONCLUSIONS: Our study suggests that patients with CKD may be more likely to develop perioperative complications after lumbar arthrodesis. Future studies are necessary to corroborate our findings.

Full Text

Duke Authors

Cited Authors

  • Adogwa, O; Elsamadicy, AA; Sergesketter, A; Oyeyemi, D; Galan, D; Vuong, VD; Khalid, S; Cheng, J; Bagley, CA; Karikari, IO

Published Date

  • February 2018

Published In

Volume / Issue

  • 110 /

Start / End Page

  • e266 - e270

PubMed ID

  • 29109065

Pubmed Central ID

  • 29109065

Electronic International Standard Serial Number (EISSN)

  • 1878-8769

Digital Object Identifier (DOI)

  • 10.1016/j.wneu.2017.10.147

Language

  • eng

Conference Location

  • United States