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

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.

• Authors: G Nergelius, L Lidgren, A Grubb, E Vinge
• Journal: Acta anaesthesiologica Scandinavica (Acta Anaesthesiol Scand) Vol. 42 Issue 8 Pg. 974-81 (Sep 1998) ISSN: 0001-5172 [Print] England
• PMID: 9773143 (Publication Type: Clinical Trial, Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• Bone Cements
• Methylmethacrylates
• Creatinine

Topics

• Aged
• Aged, 80 and over
• Albuminuria (chemically induced)
• Area Under Curve
• Arthroplasty, Replacement, Knee
• Bone Cements (adverse effects)
• Creatinine (urine)
• Female
• Humans
• Kidney Diseases (chemically induced, urine)
• Male
• Methylmethacrylates (adverse effects)
• Middle Aged
• Postoperative Complications (chemically induced, urine)
• Proteinuria (chemically induced)