Acute renal failure after total hip replacement

Eight of forty-one patients undergoing total hip replacement experienced acute but not fatal renal failure postoperatively. All forty-one patients received transfusions of frozen blood and albumin and their wounds were irrigated with a bacitracin-neomycin-polymyxin solution. All subsequently had some relative hypotension. None of a second, prospective group of fifty-five patients who received the transfusion of albumin, but not frozen blood or the bacitracin-neomycin-polymyxin irrigant, had renal failure. The incidence of hypotension in this group was comparable to that in the first group, yet no cases of renal failure were seen. We therefore recommend that the combination of frozen blood and potentially nephrotoxic drugs be avoided in patients undergoing total hip replacement.