{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,17]],"date-time":"2026-02-17T08:19:03Z","timestamp":1771316343114,"version":"3.50.1"},"reference-count":25,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2025,3,17]],"date-time":"2025-03-17T00:00:00Z","timestamp":1742169600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2025,3,17]],"date-time":"2025-03-17T00:00:00Z","timestamp":1742169600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100001232","name":"Royal Australasian College of Physicians","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100001232","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Intl J Gynecology &amp; Obste"],"published-print":{"date-parts":[[2025,8]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>This study evaluates postoperative outcomes of patients with kidney failure on chronic kidney replacement therapy after gynecological surgery.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This binational data\u2010linkage study identified patients with kidney failure via the Australia and New Zealand Dialysis and Transplant Registry who underwent major gynecological surgeries between 2000 and 2015. The primary outcome was postoperative mortality. Secondary outcomes included infective, medical, and wound complications, transfusion requirement, intensive care unit (ICU) admissions, readmissions, length of stay, and dialysis\/transplant\u2010specific outcomes. Univariable and multivariable logistic and negative binomial regression models were used.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Among the 403 patients included, 30.5% underwent abdominal hysterectomy, 19.1% vaginal hysterectomy and 50.4% ovarian surgery. Thirty\u2010day mortality and morbidity rates were 1.2% (95% confidence interval [CI]: 0.5\u20133.0) and 30.8% (95% CI: 26.3\u201335.6), respectively. Compared with abdominal hysterectomy, vaginal hysterectomy was associated with fewer transfusions (adjusted odds ratios [aOR]: 0.40, 95% CI: 0.16\u20130.98), ICU admissions (aOR: 0.28, 95% CI: 0.09\u20130.80), and shorter stays (IRR: 0.74, 95% CI: 0.55\u20130.99). Of all kidney replacement therapies, postoperative mortality was highest in patients on peritoneal dialysis (6.9%, 95% CI: 1.2\u201324.2,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.026). This cohort also required more transfusions (aOR: 2.84, 95% CI: 1.12\u20137.21) and had longer stays (IRR: 1.58, 95% CI: 1.07\u20132.33). Kidney transplant recipients had fewer ICU admissions (aOR: 0.22, 95% CI: 0.09\u20130.52) and shorter stays (IRR: 0.75, 95% CI: 0.58\u20130.96). Emergency admissions and older age correlated with poorer outcomes.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Patients on chronic kidney replacement therapy undergoing gynecological surgery demonstrated low postoperative mortality but substantial morbidity. Further research is needed to evaluate risk\u2010mitigating strategies.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ijgo.70064","type":"journal-article","created":{"date-parts":[[2025,3,17]],"date-time":"2025-03-17T08:07:13Z","timestamp":1742198833000},"page":"865-874","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Gynecological surgery in patients with kidney failure on chronic kidney replacement therapy: A binational data linkage study of morbidity and mortality outcomes"],"prefix":"10.1002","volume":"170","author":[{"ORCID":"https:\/\/orcid.org\/0009-0008-9237-1912","authenticated-orcid":false,"given":"Mina","family":"Khair","sequence":"first","affiliation":[{"name":"Metro North Kidney Service Royal Brisbane and Women's Hospital  Herston Queensland Australia"},{"name":"Faculty of Medicine University of Queensland  St Lucia Queensland Australia"},{"name":"Department of Internal Medicine Royal Brisbane and Women's Hospital  Herston Queensland Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dharmenaan","family":"Palamuthusingam","sequence":"additional","affiliation":[{"name":"Metro North Kidney Service Royal Brisbane and Women's Hospital  Herston Queensland Australia"},{"name":"Faculty of Medicine University of Queensland  St Lucia Queensland Australia"},{"name":"School of Medicine Griffith University  Southport Queensland Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Carmel M.","family":"Hawley","sequence":"additional","affiliation":[{"name":"Faculty of Medicine University of Queensland  St Lucia Queensland Australia"},{"name":"Metro South Kidney and Transplant Services Princess Alexandra Hospital  Woolloongabba Queensland Australia"},{"name":"Australasian Kidney Trials Network (AKTN) University of Queensland  St Lucia Queensland Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elaine M.","family":"Pascoe","sequence":"additional","affiliation":[{"name":"Centre for Health Services Research University of Queensland  St Lucia Queensland Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Usama","family":"Shahid","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Royal Brisbane and Women's Hospital  Herston Queensland Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David W.","family":"Johnson","sequence":"additional","affiliation":[{"name":"Metro South Kidney and Transplant Services Princess Alexandra Hospital  Woolloongabba Queensland Australia"},{"name":"Australasian Kidney Trials Network (AKTN) University of Queensland  St Lucia Queensland Australia"},{"name":"Translational Research Institute  Brisbane Queensland Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Magid","family":"Fahim","sequence":"additional","affiliation":[{"name":"Faculty of Medicine 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