Renal function not impaired by hip arthroplasty. A prospective study of 26 patients

To evaluate the importance of various changes during major surgery, 26 patients, electively chosen for total hip replacement (THR), were investigated for renal function preoperatively and postoperatively. In most of the patients, surgery was performed ad modum Charnley (n 25), and anesthesia was given mainly by continuous administration of bupivacaine or mepivacaine through an epidural catheter. Postoperatively, there was an improvement in glomerular filtration rate (GFR) and a reduction in renal concentrating ability (RCA), but no change in diurnal albumin excretion. No correlation was found between the change in GFR and, e.g., the degree of peroperative hypotension, bleeding, transfusions, or volume of infusions. There was a correlation between the impairment of RCA and the lowering of serum albumin concentration. In 3 patients the GFR was slightly impaired. The risk of contracting severe, acute renal failure seems low in THR performed on patients with reduced or normal kidney function.