Acute renal failure after total hip replacement.

Renal impairment after hip or knee arthroplasty: Urinary excretion of protein markers studied in 59 patients

“…A similar decrease in serum urea was observed by Stegmayr et al (1992) whose patients were similar to ours as regards bleeding (1 L) and transfusion (median 1 unit) . Compared to previous studies, the hip patients in our study had less bleeding (mean 0.9 L vs. 1.6 L (Hedstrom and Hybbinette 1988)) and received fewer blood transfusions (0.3-0.6 L of SAG compared to 6-13 units (Gelman et al 1979) or 2.1 L blood (Isacson and Collert 1984)). In accordance with more recent principles in transfusion therapy (Miller 1994), they were given more cristalloids and dextran than blood products.…”

“…Previous studies have indicated postoperative renal impairment in about 10-15% of all patients undergoing hip arthroplasty (Gelman et al 1979), mainly in patients on systemic antibiotic prophylaxis with isoxazolyl penicillins (Isacson and Collert 1984, Hedstrom and Hybbinette 1988, Ahnfelt and Steen 1992, Wahlstrom et al 1992a. However, in patients receiving dicloxacillin and operated with gentamicinfree bone cement, only slight signs of tubular dysfunction were found one week after surgery (Stegmayr et al 1992).…”

Renal function not Impaired by hip arthroplasty

“…The surgical trauma may even lead to renal failure, and the risk of such failure occurring increases with the extent of tissue damage, from hypotension, from multiple blood transfusions (Sherman 1982, Shin et al 1986, and in cases with postoperative infections (Heloury et al 1983, Wilkins and Faragher 1983, Myers and Moran 1986. In total hip replacement (THR), these risk factors are often present, and severely impaired renal function has been reported to occur in more than 10 percent of the patients (Gelman et al 1979, Isacson and Collert 1984, Hedstrom and Hybbinette 1988. To our knowledge, no prospective study of THRs has evaluated the changes in kidney function on a more definitive basis by plasma clearance as regards glomerular filtration rate.…”

Acute Renal Failure Caused by Polymyxin B Containing Ointment

“…In the past, acute renal failure has been caused by polymyxin in a few cases, when polymyxin was administered non-parenteral (2). The patients had all undergone surgery because of hop-joint arthrosis.…”