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Renal dysfunction after total knee replacement is not aggravated by bone cement
G Nergelius1, L Lidgren, A Grubb
1Department of Anesthesia and Intensive Care, University Hospital, Lund, Sweden.
Acta Anaesthesiologica Scandinavica
|October 17, 1998
Summary
Total knee replacement (TKR) can cause temporary kidney problems, specifically increased protein leakage indicating glomerular and tubular dysfunction. This renal effect was not linked to the use of monomeric methylmethacrylate (MMA) bone cement.
Area of Science:
- Nephrology
- Orthopedic Surgery
- Biochemistry
Background:
- Total knee replacement (TKR) is linked to postoperative renal dysfunction.
- Monomeric methylmethacrylate (MMA) bone cement may contribute to hypotension via multiple mechanisms.
Purpose of the Study:
- To investigate renal function following TKR.
- To determine if MMA bone cement influences postoperative renal dysfunction.
Main Methods:
- Serum and urinary markers of renal function (creatinine, cystatin C, albumin, IgG, protein HC) were measured in 30 TKR patients.
- Patients were divided into two groups: those who received MMA bone cement (n=16) and those who did not (n=14).
- Measurements were taken preoperatively and on postoperative days 1, 2, 4, and 8.
Main Results:
- A transient, five-fold increase in creatine kinase (CK) and a continuous rise in cystatin C were observed in both groups.
- Postoperative urinary protein levels increased, with peak elevations in glomerular markers on day 1 and tubular markers on day 2.
- No significant differences in proteinuria were found between the MMA bone cement and non-cement groups.
Conclusions:
- Postoperative TKR is associated with transient glomerular and tubular dysfunction, evidenced by increased urinary protein leakage.
- The use of MMA bone cement did not significantly impact the observed postoperative renal dysfunction or proteinuria.