Benefits of Continuous Outpatient Orthopedic Consultations for Both Upper and Lower Body on the Mortality Rates of Hemodialysis Patients.

Background: The purpose of the present observational study was to examine whether there is a difference in prognosis for hemodialysis patients with or without continued orthopedic outpatient visits over five years.  Methods: One hundred and thirteen hemodialysis patients who visited the dialysis center of Takagi Hospital, Okawa, Japan, as of December 2017 were included in this study. Data were collected from the medical records until December 2022. All 113 patients were divided into two groups: patients who continuously visited the orthopedic outpatient department (n = 59) and those who did not (n = 54). Patients who had orthopedic consultation were divided into three semi-groups: patients who consulted for the upper body (n = 11), the lower body (n = 22), and both the upper and lower bodies (n = 26).

Results: During the five-year follow-up period, 13 out of 59 patients (22.0%) who had orthopedic consultation died, and this ratio tended to be lower compared to the mortality rate of patients without orthopedic consultation (37.0%) but not significant (P < 0.08). Duration of hemodialysis was significantly longer in patients with orthopedic consultation (P = 0.009). The mortality rate was significantly lower in patients who consulted for both upper and lower bodies than those without orthopedic consultation (P < 0.05, respectively). These differences were not observed in patients who consulted for only upper or lower bodies.

Conclusion: The mortality of hemodialysis patients was significantly lower in the group which was undertaking continuous outpatient orthopedic consultations for both upper and lower bodies, which suggested that periodical consultation with orthopedics might be critical for hemodialysis patients.