CKD Linked to Higher Complication Risk After Mohs Surgery

Key Takeaways

• Chronic kidney disease (CKD) was associated with increased postoperative complications following Mohs micrographic surgery (MMS).
• Early complications included infection and dehiscence; delayed healing and graft-related issues emerged at 90 days.
• Findings highlight the need for tailored perioperative counseling and monitoring in patients with CKD undergoing MMS.

Chronic kidney disease (CKD) was associated with increased postoperative complications following Mohs micrographic surgery (MMS), according to results of a study published as a Research Letter in the Journal of Drugs in Dermatology

Authors evaluated postoperative outcomes in patients with chronic kidney disease (CKD) undergoing Mohs micrographic surgery (MMS) for nonmelanoma skin cancer (NMSC). Using the TriNetX Research Network, investigators identified 25,016 matched pairs of patients with and without CKD who underwent MMS for basal cell carcinoma or squamous cell carcinoma between July 2020 and July 2025.

At 30 days, CKD was associated with a higher risk of surgical site infection (risk ratio [RR] 1.29, P = 0.047) and wound dehiscence (RR 1.61, P = 0.019). By 90 days, delayed wound healing (RR 1.44, P = 0.0062) and graft complications (RR 2.18, P = 0.0077) occured. Elevated risks of infection (RR 1.32, P = 0.021) and dehiscence (RR 1.40, P = 0.012) persisted over time.

The authors said findings align with known CKD-related pathophysiology, including chronic inflammation, uremia, and microvascular dysfunction, which may impair tissue repair.

Study limitations included reliance on ICD-10 coding, lack of procedural detail and absence of perioperative management data. Despite these constraints, the analysis suggests CKD may independently increase postoperative risk following MMS.