Enfermedad renal crónica como factor de riesgo para complicaciones posterior a la artroplastia de miembros inferiores

Abstract

Arthroplasties of the lower limbs are some of the most common orthopedic surgical procedures which are utilized, mainly, in patients with osteoarthritis (OA). This is degenerative disorder characterized by inflammatory mechanisms which affect cell types in the joints and can alter the functionality of other organs such as the kidneys, and thus, lead to the development of chronic kidney disease (CKD). At the same time, scientific evidence has demonstrated that CKD is implicated in proinflammatory processes associated with both, the development and the progression of OA. Likewise, numerous studies support the role of CKD as a risk factor for complications following total hip arthroplasty (THA) and total knee arthroplasty (TKA), such as wound infections, pneumonia, and cardiopulmonary events, as well as increased mortality rates and revision surgeries in these patients. In this scenario, orthopedic surgeons are advised to perform a correct perioperative assessment of patients with CKD in order to reduce post-operative risks of THA and TKA. The objective of this review article is to describe the relationship among OA, CKD, and arthroplasties of the lower limbs, as well as to collect and present the scientific evidence supporting the role of CKD as a risk factor for complications after these surgical procedures.