Background: Osteoarthritis (OA) is a debilitating condition often treated with total knee arthroplasty (TKA), a procedure effective in alleviating pain but associated with potential renal complications, including acute kidney injury (AKI) and chronic kidney disease (CKD).While perioperative risks are known, long-term kidney-related outcomes of TKA remain underexplored.This study investigates the association between TKA and the risks of new-onset AKI and CKD compared to non-surgical OA management.Method: A retrospective cohort study using the TriNetX Research Network included adults with OA who underwent TKA (n=41,027) and matched non-surgical controls (n=41,027).Propensity score matching balanced demographics, comorbidities, and medical utilization.Renal outcomes were assessed using Hazard ratios (HRs) and 95% confidence intervals (CIs) were evaluated.Sensitivity and stratified analyses evaluated robustness and subgroup-specific risks.Results: TKA significantly increased the risk of AKI (HR: 1.48, 95% CI: 1.40-1.57)and CKD (HR: 1.30, 95% CI: 1.24-1.37).Females showed higher risks of AKI (HR: 1.55, 95% CI: 1.44-1.67)and CKD (HR: 1.32, 95% CI: 1.24-1.40).Younger patients (18-64 years) exhibited elevated risks of AKI (HR: 1.90, 95% CI: 1.56-2.31)and CKD (HR: 1.73, 95% CI: 1.38-2.18).Sensitivity analyses confirmed consistent results across various models.Conclusion: TKA is associated with increased risks of AKI and CKD, particularly in females and younger patients.These findings underscore the need for enhanced perioperative care, renal risk stratification, and long-term monitoring to mitigate adverse renal outcomes in TKA recipients.
Chen et al. (Tue,) studied this question.