투석을 시행하는 만성 신부전 환자의 인공 고관절 치환술 시 합병증에 대한 분석

초록

Purpose: In general, the results and prognosis of surgical treatment in dialysis patients are poor compared to patients with normal kidney function. This study analyzes the complications in chronic renal failure patients who underwent primary hip arthroplasty for hip fractures and arthropathy. Orthopaedic complications and medical complications were analyzed for a consequential difference. Materials and Methods: Between 2003 and 2008, 38 dialysis patients (40 cases) with chronic renal failure were enrolled with 24cases of bipolar hemiarthroplasty and 16 cases of total hip arthroplasty. Types and rates of orthopaedic and medical complications were investigated. Patients were classifi ed according to age, gender, duration of dialysis and diabetes mellitus status. Complications were analyzed for each group. Results: Complications occurred in 15 patients (overall complication rate: 37.5%). Eight patients were died within 1 year (mortality:20%). Gender and duration of dialysis were not correlated to number of complications. However, there were signifi cant differences according to age (p=0.014) and having diabetes (p=0.026). With regard to mortality, there was no signifi cant difference according to the above classifi cation. Conclusion: Patients on hemodialysis have a high risk of complications after primary hip arthroplasty, especially in elderly patients and diabetic patients. Therefore, we require a full disclosure before recommending hip arthroplasty surgery in dialysis patients, and close postoperative care in patients undergoing dialysis.

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