Compared to previous study, the incidence of postoperative thrombocytopenia (4.9% vs. 0.37%), pulmonary embolism (0.32% vs. 0.2%), acute myocardial infarction (1.46% vs. 0.51%) and blood transfusion (11.83% vs. 0.7%) in patients with DKD receiving THA were higher, which may be related to decreased renal function/erythropoietin production, iron deficiency, side effects of hypoglycaemic drugs and diabetic microangiopathy in patients with DKD [26, 27]. Here, EPO is linked to Iron deficiency anemia.