The impact of chronic kidney disease and dialysis therapy on outcomes of elderly patients with hip fractures: A systematic review and meta-analysis.

ABSTRACT

BACKGROUND AND AIMS: Hip fractures are a commonly occurring comorbidity in patients with chronic kidney disease. To evaluate the comparative rates of post-operative complications, revision surgery, and mortality after hip fracture surgery in chronic kidney disease patients undergoing hemodialysis. METHODS: A systematic search of the academic literature was performed according to the PRISMA guidelines across five databases Web of Science, EMBASE, CENTRAL, Scopus, and MEDLINE. A random-effect meta-analysis was conducted to evaluate the overall comparative risks of post-operative complications in chronic kidney disease patients. RESULTS: Out of 993 studies, 11 eligible studies were included in the review, with a total of 72618 chronic kidney disease patients (mean age 75.3 ± 3.0 years), and 50566 healthy controls (75.3 ± 2.6 years). Meta-analysis revealed a higher risk of post-operative complications (Odd's ratio 1.76), revision surgeries (1.69), and mortality-related outcomes (2.47) after hip fracture surgery in chronic kidney disease patients undergoing hemodialysis as compared to chronic kidney disease patients not undergoing hemodialysis. CONCLUSION: We report higher risks of post-operative complications, revision surgery, and mortality in chronic kidney disease patients undergoing hemodialysis as compared to chronic kidney disease patients not undergoing hemodialysis.