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首页> 外文期刊>Journal of nephrology. >Total hip arthroplasty in chronic dialysis patients in the United States.
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Total hip arthroplasty in chronic dialysis patients in the United States.

机译：美国的慢性透析患者的全髋关节置换术。

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摘要

BACKGROUND: The national incidence of and factors associated with total hip arthroplasty (THA) in chronic dialysis patients has never been reported. METHODS: We therefore performed an historical cohort study of 375,857 chronic dialysis patients listed in the 2000 United States Renal Data System between 1 April 1995 and 31 December 1999 and followed-up until 14 May 2000. Primary outcomes were associations with hospitalizations for a primary discharge code of THA (ICD9 procedure code 81.51x) after initiation of dialysis. RESULTS: Dialysis patients had a cumulative incidence of THA of 35 episodes/10,000 person-years, compared to 5.3/10,000 in the general population. The leading indication for THA was osteoarthritis of the hip and pelvis (58% of cases). However, the strongest risk factor for THA in dialysis patients was end-stage renal disease (ESRD) due to systemic lupus erythematosus (SLE, adjusted rate ratio (ARR), 6.80, 95% CI 4.62-10.03, in whom avascular necrosis of the hip was the most common indication, 68.4%). The database did not include information on use of corticosteroids. Diabetic recipients were significantly less likely to receive THA, as were males, and African Americans. Mortality after THA was 0.25% at thirty days and 30% at three years, not significantly different from the expected mortality of dialysis, adjusted for comorbidity. CONCLUSIONS: The most common indication for THA in dialysis patients is osteoarthritis of the hip, similar to the general population. Patients with SLE are more likely to receive THA which is well tolerated and not associated with increased mortality in this population, perhaps reflecting selection bias due to appropriate screening for this elective procedure.
机译：背景：慢性透析患者全髋关节置换术（THA）的全国发病率和相关因素尚未见报道。方法：因此，我们对1995年4月1日至1999年12月31日在2000年美国肾脏数据系统中列出的375,857名慢性透析患者进行了历史队列研究，并随访至2000年5月14日。主要结局是与因一次出院而住院有关透析开始后的THA代码（ICD9程序代码81.51x）。结果：透析患者的THA累积发生率为35次发作/ 10,000人年，而一般人群中为5.3 / 10,000。 THA的主要指征是髋部和骨盆的骨关节炎（58％的病例）。然而，在透析患者中​​，THA的最强危险因素是由于系统性红斑狼疮（SLE，调整率比（ARR），6.80，95％CI 4.62-10.03）导致的终末期肾脏疾病（ESRD），其中髋关节是最常见的适应症，占68.4％。该数据库不包括有关使用皮质类固醇的信息。糖尿病接受者，男性和非裔美国人接受THA的可能性大大降低。经合并症调整后，THA术后30天的死亡率为0.25％，三年为30％，与预期的透析死亡率无显着差异。结论：透析患者中​​THA最常见的适应症是髋关节骨关节炎，与普通人群相似。 SLE患者更有可能接受THA，THA耐受性良好，且与该人群的死亡率增加无关，这可能反映了由于对该选择性手术进行适当筛查而导致的选择偏倚。

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