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

Abstract

We studied renal function during and after surgery in 38 patients undergoing total hip replacement (THR) and 21 patients undergoing total knee replacement (TKR). Serum creatinine and renal excretion of albumin, IgG, protein HC and creatinine were recorded preoperatively and on days 1, 2, 4, and 8. THR patients were randomized to treatment with (n 17) or without (n 21) prophylactic isoxazolyl penicillins, which all TKR patients had. In all 3 groups, the urinary concentration of proteins increased postoperatively with a peak in the glomerular markers (albumin, IgG) on days 1 and 2, and in the tubular marker (protein HC) on days 2 and 4. There were no statistically significant differences between the groups. On day 8, all urinary protein concentrations had essentially returned to their preoperative levels. Serum creatinine decreased by 10% in THR patients on day 1 and then returned to baseline levels, but there was a gradual increase up to 13% in TKR patients.