Faculty Collaboration Database

Nephrotoxicity After the Treatment of Periprosthetic Joint Infection With Antibiotic-Loaded Cement Spacers. J Arthroplasty 2018 Jul;33(7):2225-2229

Date

03/13/2018

Pubmed ID

29526331

DOI

10.1016/j.arth.2018.02.012

Scopus ID

2-s2.0-85042914351 (requires institutional sign-in at Scopus site)   36 Citations

Abstract

BACKGROUND: Treatment of periprosthetic joint infections commonly involves insertion of an antibiotic-loaded cement spacer (ACS). The risk for acute kidney injury (AKI) related to use of antibiotic spacers has not been well defined. We aimed to identify the incidence of and risk factors for AKI after placement of an ACS.

METHODS: We performed a prospective cohort study of patients with an infected primary total hip or knee arthroplasty treated with ACSs with vancomycin, gentamicin, and tobramycin. Serum creatinine and glomerular filtration rate data were collected at baseline and weekly intervals for 8 weeks. Patients were classified into Risk, Injury, Failure, Loss of kidney function, and End-stage kidney disease (RIFLE) stages to determine incidence of AKI. Risk factors for kidney injury were identified via regression analysis.

RESULTS: A total of 37 patients (20 total knee arthroplasty and 17 total hip arthroplasty) were included. During the 8 weeks after ACS placement, 10 patients (27%) fit RIFLE criteria for kidney injury and 2 patients (5%) fit RIFLE criteria for kidney failure. No baseline patient characteristics were associated with development of AKI.

CONCLUSION: Patients should be monitored closely for development of AKI after placement of ACSs for the treatment of periprosthetic joint infection. Further research into minimizing risk for AKI is warranted.

Author List

Edelstein AI, Okroj KT, Rogers T, Della Valle CJ, Sporer SM

MESH terms used to index this publication - Major topics in bold

Acute Kidney Injury
Aged
Aged, 80 and over
Anti-Bacterial Agents
Arthritis, Infectious
Arthroplasty, Replacement, Hip
Arthroplasty, Replacement, Knee
Creatinine
Female
Gentamicins
Humans
Illinois
Incidence
Male
Middle Aged
Prospective Studies
Prosthesis-Related Infections
Reoperation
Risk Factors
Tobramycin
Vancomycin