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Renal dysfunction after total knee replacement is not aggravated by bone cement
Author(s) -
Nergelius G.,
Lidgren L.,
Grubb A.,
Vinge E.
Publication year - 1998
Publication title -
acta anaesthesiologica scandinavica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.738
H-Index - 107
eISSN - 1399-6576
pISSN - 0001-5172
DOI - 10.1111/j.1399-6576.1998.tb05358.x
Subject(s) - medicine , creatinine , cystatin c , renal function , urology , creatine kinase , proteinuria , bone cement , albumin , urinary system , kidney , endocrinology , cement , archaeology , history
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.