• Owoicho Adogwa, Aladine A Elsamadicy, Amanda Sergesketter, Deborah Oyeyemi, Diego Galan, Victoria D Vuong, Syed Khalid, Joseph Cheng, Carlos A Bagley, and Isaac O Karikari.
• Department of Neurosurgery, Rush University Medical Center, Chicago, Illinois. Electronic address: owoicho.adogwa@gmail.com.
• World Neurosurg. 2018 Feb 1; 110: e266-e270.

ObjectiveTo determine whether preoperative chronic kidney disease (CKD) is associated with inferior perioperative outcomes in patients undergoing lumbar arthrodesis.MethodsMedical records of 293 adult (≥18 years old) patients with spine deformity undergoing elective lumbar spine decompression and fusion at a major academic institution from 2006 to 2015 were reviewed. We identified 18 (6.1%) patients with a clinical diagnosis of CKD (CKD group, n = 18; no-CKD group, n = 275). Patient demographics, comorbidities, and intraoperative and postoperative complication rates were collected for each patient. The primary endpoint was incidence of postoperative complications.ResultsPatient demographics, including age, sex, and body mass index, and comorbidities were similar between cohorts. The CKD group had a significantly higher prevalence of hypertension, hyperlipidemia, and anemia compared with the no-CKD group. Median number of fusion levels, length of surgery, and estimated blood loss were similar between both cohorts. Postoperative complication profile was significantly different between the cohorts, with the CKD group having a significantly higher proportion of patients transferred to the intensive care unit (52.9% vs. 29.3%, P = 0.04) with episodes of delirium (27.8% vs. 8.4%, P = 0.007), urinary tract infection (27.8% vs. 6.9%, P = 0.0002), and deep vein thrombosis (5.6% vs. 0.4%, P = 0.01). Although not significant, the CKD group had a 2-fold higher rate of 30-day readmissions compared with the no-CKD group (CKD group: 27.8% vs. no-CKD group: 12.7%, P = 0.07).ConclusionsOur study suggests that patients with CKD may be more likely to develop perioperative complications after lumbar arthrodesis. Future studies are necessary to corroborate our findings.Copyright © 2017 Elsevier Inc. All rights reserved.

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