Key result
Dialysis dependence in younger men is linked to ~13-fold higher major surgery rates.
Why the study?
Chronic kidney disease prevalence and mortality have risen significantly, with a high frequency of surgical interventions in this population, especially among dialysis-dependent patients.
Effect estimate: 13-fold increase
Highlights the disproportionately high surgical burden in patients with advanced CKD and dialysis dependence, emphasizing the need for specialized perioperative risk assessment.
Elevated surgical rates in low-eGFR patients warrant perioperative caution; extends epidemiologic observations but leaves optimal management strategies open.
Over the last three decades, chronic kidney disease (CKD) prevalence and mortality have risen significantly.1 Epidemiologic evidence underscores the high frequency of surgical intervention in this population.2 A large study of over 1.4 million North American adults revealed that individuals with lower estimated glomerular filtration rate (eGFR) undergo major surgery at significantly higher rates than those with preserved kidney function. This surgical burden is particularly pronounced in dialysis-dependent populations; for instance, the incidence rate of major surgery for men under age 65 receiving dialysis is 243.8 per 1,000 person-years, a 13-fold increase over the G1-G2 cohort.
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Yadlapalli et al. (2026) conducted a review in Chronic Kidney Disease, Dialysis Dependence, and Kidney Transplantation (n=1,400,000). Lower estimated glomerular filtration rate (eGFR) and dialysis dependence vs. Preserved kidney function (G1-G2 cohort) was evaluated on Incidence rate of major surgery (13-fold increase). Dialysis dependence in men under age 65 is associated with a major surgery rate of 243.8 per 1,000 person-years, a 13-fold increase compared to patients with preserved kidney function.
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