title: Effects of hip arthroplasty and peroperative dicloxacillin prophylaxis on renal function.
abstract: In a prospective pilot study 70 patients (age greater than 65 years) who underwent hip arthroplasty were treated with dicloxacillin, a total of 6 g given pre-, per- and postoperatively as antibiotic prophylaxis. Creatinine in serum and beta 2-microglobulin in serum and urine were determined as estimates of renal function. Values were obtained preoperatively and on days 2, 4 and 10 after operation. A slight but significant increase of serum creatinine was seen on day 2 with a gradual decrease almost down to the preoperative baseline value on day 10. Serum beta 2-microglobulin increased more gradually; the increase was significant on day 10. Raised levels of beta 2-microglobulin in urine were most pronounced: a 20-fold increase on day 2, then a slow decrease, still significant increase on day 10. This may indicate a reversible damage of proximal tubules with blocked tubular reabsorption of beta 2-microglobulin. The slightly increased levels of serum creatinine and beta 2-microglobulin would also indicate a minor reversible decrease in glomerular filtration rate. Whether these effects are caused by the operation trauma per se or by the dicloxacillin prophylaxis cannot be determined from this pilot study. It seems quite clear that hip arthroplasty with short term prophylaxis with dicloxacillin does not result in clinically important changes in renal function.
authors.affiliation: Department of Orthopaedic Surgery, University Hospital, Faculty of Health Sciences, Linköping, Sweden.
authors.forename: O
authors.initials: O
authors.lastname: Wahlström
authors.forename: R
authors.initials: R
authors.lastname: Maller
authors.forename: R
authors.initials: R
authors.lastname: Larsson
authors.forename: B
authors.initials: B
authors.lastname: Kågedal
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001424:Bacterial Infections / Q000517:prevention & control*; D003404:Creatinine / Q000097:blood; D004009:Dicloxacillin / Q000009:adverse effects / Q000627:therapeutic use*; D005260:Female; D006622:Hip Prosthesis; D006801:Humans; D007432:Intraoperative Period; D007668:Kidney / Q000187:drug effects / Q000502:physiology*; D007677:Kidney Function Tests; D008297:Male; D009102:Multiple Organ Failure / Q000209:etiology; D010865:Pilot Projects; D011014:Pneumonia / Q000209:etiology; D011183:Postoperative Complications; D011446:Prospective Studies; D012772:Shock, Septic / Q000209:etiology; D001613:beta 2-Microglobulin / Q000652:urine
chemical_list: D001613:beta 2-Microglobulin; D003404:Creatinine; D004009:Dicloxacillin