title: Postoperative Impact of Diabetes, Chronic Kidney Disease, Hemodialysis, and Renal Transplant After Total Hip Arthroplasty.
abstract: The prevalence of diabetes mellitus (DM), chronic kidney disease (CKD), hemodialysis (HD), and renal transplantation (RT) is increasing. This study assessed postoperative complications among diabetic patients with CKD, HD, or post-RT after total hip arthroplasty (THA).
  
  
  
  Four cohorts were created using a nationwide database: DM&THA, DM&CKD&THA, DM&HD&THA, and DM&RT&THA. Cohorts were matched to a control group by age and gender. Thirty-day medical complications and 90-day and 2-year surgical complications were evaluated.
  
  
  
  All 30-day complications were higher in each cohort. Ninety-day and 2-year surgical complications in the DM&HD&THA cohort were increased compared to the DM&RT&THA cohort. Remarkably, no increased risk of periprosthetic joint infection, periprosthetic fracture, or revision was noted post-THA in the DM&RT&THA cohort.
  
  
  
  Diabetic patients with worsening kidney function are associated with increased post-THA complications. Postsurgical risks decline following RT. Diabetic patients with kidney failure may want to undergo RT prior to THA to optimize surgical outcomes.
authors.affiliation: Department of Orthopaedic Surgery, Duke University Medical Center, Durham, North Carolina.
authors.forename: Beau J
authors.initials: BJ
authors.lastname: Kildow
authors.affiliation: Department of Orthopaedic Surgery, Duke University Medical Center, Durham, North Carolina.
authors.forename: Perez
authors.initials: P
authors.lastname: Agaba
authors.affiliation: Department of Orthopaedic Surgery, Duke University Medical Center, Durham, North Carolina.
authors.forename: Brian F
authors.initials: BF
authors.lastname: Moore
authors.affiliation: Department of Orthopaedic Surgery, Duke University Medical Center, Durham, North Carolina.
authors.forename: Rhett K
authors.initials: RK
authors.lastname: Hallows
authors.affiliation: Department of Orthopaedic Surgery, Duke University Medical Center, Durham, North Carolina.
authors.forename: Michael P
authors.initials: MP
authors.lastname: Bolognesi
authors.affiliation: Department of Orthopaedic Surgery, Duke University Medical Center, Durham, North Carolina.
authors.forename: Thorsten M
authors.initials: TM
authors.lastname: Seyler
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001170:Arthritis, Infectious / Q000209:etiology; D019644:Arthroplasty, Replacement, Hip / Q000009:adverse effects*; D048909:Diabetes Complications / Q000453:epidemiology* / Q000209:etiology; D003920:Diabetes Mellitus; D005260:Female; D006801:Humans; D016030:Kidney Transplantation; D008297:Male; D057068:Periprosthetic Fractures / Q000601:surgery; D011183:Postoperative Complications / Q000453:epidemiology* / Q000209:etiology; D011184:Postoperative Period; D006435:Renal Dialysis; D051436:Renal Insufficiency, Chronic / Q000150:complications* / Q000628:therapy; D012189:Retrospective Studies
keywords: chronic kidney disease; diabetes; hemodialysis; renal transplantation; total hip arthroplasty