“We hope our findings can help make hip or knee replacement surgery safer for patients with chronic kidney disease,” - Dr. Tzu-Fei WangSurgery comes with a risk of blood clots, especially joint replacement surgery, so patients are given blood thinners to prevent clots from forming. People with chronic kidney disease are already at higher risk of blood clots and major bleeding due to their illness. However, the best way to prevent clots after surgery in this population is unknown, as they are often excluded from clinical trials. 

To help fill this knowledge gap, Dr. Tzu-Fei Wang led a study that looked at data from 27,645 Ontarians aged 66 and older with chronic kidney disease who had a hip or knee replacement between 2010 and 2020. The team found that a newer kind of blood thinner called direct-oral anticoagulants was linked with a lower risk of blood clots after hip or knee replacement surgery, but also a higher risk of bleeding in this population compared to the more traditional blood thinner low-molecular-weight heparin. 

Their findings published in the American Journal of Hematology could help guide discussions between physicians and patients about the best approach for preventing blood clots after this type of surgery.  

“We hope our findings can help make hip or knee replacement surgery safer for patients with chronic kidney disease,” - Dr. Tzu-Fei Wang, hematologist and associate scientist at The Ottawa Hospital and associate professor at the University of Ottawa.

Authors: Tzu-Fei Wang, Nicholas Grubic, Marc Carrier, Mark Canney, Aurélien Delluc, Gregory L. Hundemer, Gregory Knoll, Alejandro Lazo-Langner, David Massicotte-Azarniouch, Peter Tanuseputro, Manish M. Sood

Funding: ICES. All research at The Ottawa Hospital is enabled by generous donors to The Ottawa Hospital Foundation.

Core resources: ICES uOttawa

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