Acute Kidney Injury After Placement of an Antibiotic-Impregnated Cement Spacer During Revision Total Knee Arthroplasty
- 作者：Travis J. Menge ; MD<sup>鈦?/sup><sup> ; sup> ; John R. Koethe ; MD<sup>&dagger ; sup> ; Cathy A. Jenkins ; MS<sup>&Dagger ; sup> ; Patty W. Wright ; MD<sup>&dagger ; sup> ; Andrew A. Shinar ; MD<sup>鈦?/sup> ; Geraldine G. Miller ; MD<sup>&dagger ; sup> ; Ginger E. Holt ; MD<sup>鈦?/sup>
- 关键词：revision knee arthroplasty ; antibiotic spacer ; acute kidney injury
- 刊名：The Journal of Arthroplasty
- 出版年：2012
- 期刊代码：326_08835403
- 类别：med
- 出版时间：June, 2012
- 卷：27
- 期：6
- 页码：1221-1227.e2
- 文件大小：173 K
摘要
We performed a retrospective cohort study of 84 patients to determine the incidence and predictors of acute kidney injury after antibiotic-impregnated cement spacer (ACS) placement for infected total knee arthroplasties. Acute kidney injury was defined as a more than 50%rise in serum creatinine from a preoperative baseline to a level greater than 1.4 mg/dL within 90 days postoperatively. Total incidence was 17%(n = 14; 95%confidence interval [CI], 10%-26%), and acute kidney injury was significantly associated with ACS tobramycin dose as both a dichotomous variable (>4.8 g; odds ratio, 5.87; 95%CI, 1.43-24.19; P = .01) and linear variable (odds ratio, 1.24 for every 1-g increase; 95%CI, 1.00-1.52; P = .049). Routine monitoring of serum creatinine and measurement of serum aminoglycoside levels in response to a threshold creatinine rise may be warranted after the placement of an aminoglycoside-containing ACS.