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Renal dysfunction after total knee replacement is not aggravated by bone cement.

G Nergelius·L Lidgren·A Grubb·E Vinge
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Abstract

BACKGROUND: Total knee replacement (TKR) has been associated with postoperative renal dysfunction. The use of monomeric methylmethacrylate (MMA) bone cement causes hypotension by several mechanisms. METHODS: In 30 patients undergoing TKR with (n = 16), or without (n = 14) bone cement, serum levels of creatinine, cystatin C and creatine kinase (CK) and urinary levels of creatinine and markers for glomerular (albumin, IgG) and tubular (protein HC) function were recorded preoperatively and on days 1, 2, 4 and 8 postoperatively. RESULTS: There were no changes in serum creatinine. Both groups had a transient, 5-fold rise in CK and a continuous increase in cystatin C. The urinary concentration of proteins increased postoperatively with a peak in the glomerular markers on day 1 and in the tubular marker on day 2. There were no significant differences in proteinuria between the groups. The 95% CIs for the difference in the means of the AUCs of the logarithmically transformed values for the proteins were never more than 19%. On day 8 all proteins had returned to their preoperative levels. CONCLUSION: Postoperatively, there was a transient increased leakage of proteins, indicating glomerular and tubular dysfunction. This was not influenced by the use of MMA bone cement.

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AgedAged, 80 and overAlbuminuriaArea Under CurveArthroplasty, Replacement, KneeBone CementsCreatinineFemaleHumansKidney DiseasesMaleMethylmethacrylatesMiddle AgedPostoperative ComplicationsProteinuriaClinical TrialJournal ArticleResearch Support, Non-U.S. Gov't

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G Nergelius, L Lidgren, A Grubb, E Vinge. 1998. Renal dysfunction after total knee replacement is not aggravated by bone cement.. https://doi.org/10.1111/j.1399-6576.1998.tb05358.x

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