Renal function not Impaired by hip arthroplasty

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

“…This differs from the results in previous studies (Isacson and Collert 1984, Hedstrom and Hybbinette 1988, Wahlstrom et al 1992a, and is probably a dilutional effect. 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)).…”

“…Stegmayr et al (1992) and Wahlstrom et al (1992a, b) also noted signs of tubular involvement after THR. These findings suggest that the kidneys have been exposed to a mild degree of medullary ischemia as shown in animal experiments (Mason et al 1987) or to some other factor associated with the surgical procedure that has caused tubular dysfunction.…”

“…The increased urinary excretion of albumin and IgG found in this study may reflect the kidneys' physiological reaction to surgical stress. Stegmayr et al (1992) found no increased excretion of albumin after THR, but they collected urine only on the fourth postoperative day and may have missed the earlier peak.…”

“…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). There is a decline in renal excretion of O-lactam antibiotics in elderly patients (Ljungberg and Nilsson-Ehle 1987); subsequently there could be a risk of accumulation of isoxazolyl penicillins and a greater impact on renal function .…”

Chronic renal failure due to amyloid nephropathy caused by chronic infection after total hip replacement

“…Assuming that chronic infection had been persistent after THR, we could have prevented secondary amyloidosis if the source of infection had been identified sooner [9]. In one report, THR was not associated with reduced kidney function [10]. However, another study reported reduction of renal function following artificial joint replacement [11].…”