ArticleInternational journal of medical sciences2026
New-onset renal diseases after total knee arthroplasty in patients with osteoarthritis: a multicenter retrospective cohort study.
Article in International journal of medical sciences, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
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.
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