Can total joint arthroplasty be safely performed in patients with chronic kidney disease?

Patients suffered from chronic kidneydisease are at greater risk of perioperative and postoperative complications. Actually there is no systerm review study demonstrating advantages of total joint arthroplasty can be safely performed in patients with chronic kidney disease.
Literature search was performed inPubMed, Embase, Web of Science, China National Knowledge Infrastructure(CNKI),Wanfang and Cochrane Library for information from the earliest date of data collection to September 2018. Studies comparing the perioperative, postoperative outcomes of No-CKD with those of CKD patients were included. Statistical heterogeneity was quantitatively evaluated by X2 test with the significance set P<0.10 or I2 > 50%.
Three papers consisting of 38,209 patients were included (35,363 No-CKD patients; 2,846 CKD patients). The results showed that CKD was related to a greater increase in postoperative infection rate, deep vein thrombosis, re-admission and mortality(P<0.1). No differences inlength of surgery, length of stay, pulmonary embolism and revision (P>0.10).
Compared with No-CKD patients, CKD patients demonstrated an increased risk of perioperative and postoperative complications and clear difference about complications between No-CKD and CKD about patients with chronic kidneydisease.