Association of Acute Kidney Injury With Antibiotic Loaded Cement Used for Treatment of Periprosthetic Joint Infection

Antibiotic-loaded bone cement (ALBC) is commonly used in the treatment of periprosthetic joint infections (PJIs) to increase the local concentration of antibiotic at the site of infection. Use of ALBC has been associated with rare instances of acute kidney injury (AKI) despite low systemic absorptio...

Full description

Saved in:
Bibliographic Details
Published in:The Journal of arthroplasty 2023-12, Vol.38 (12), p.2704-2709.e1
Main Authors: Savas, Matthew J., Gray, Kristine F., Blackburn, Brenna E., Pelt, Christopher E., Gililland, Jeremy M., Certain, Laura K.
Format: Article
Language:English
Subjects:
acute kidney injury
Acute Kidney Injury - epidemiology
Acute Kidney Injury - etiology
Acute Kidney Injury - therapy
Anti-Bacterial Agents - adverse effects
antibiotic toxicity
antibiotic-loaded bone cement
Arthritis, Infectious - etiology
Arthroplasty, Replacement, Knee - adverse effects
Bone Cements - adverse effects
debridement and implant retention
Diuretics
Humans
periprosthetic joint infection
Prosthesis-Related Infections - drug therapy
Prosthesis-Related Infections - epidemiology
Prosthesis-Related Infections - etiology
Retrospective Studies
Treatment Outcome
Vancomycin - adverse effects
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Antibiotic-loaded bone cement (ALBC) is commonly used in the treatment of periprosthetic joint infections (PJIs) to increase the local concentration of antibiotic at the site of infection. Use of ALBC has been associated with rare instances of acute kidney injury (AKI) despite low systemic absorption of the nephrotoxic antibiotics; however, the incidence of AKI is unknown. The purpose of this study was to determine the incidence of and risk factors for AKI associated with ALBC. This single-site, retrospective cohort study compared 162 PJI patients who underwent Stage 1 revision to a spacer with ALBC to 115 PJI patients who underwent debridement, antibiotics, and implant retention (DAIR) without the use of ALBC. Both groups received similar systemic antibiotics postoperatively. Descriptive statistics and multivariable logistic regressions were used to analyze risk factors for AKI. There was no statistically significant difference in the rate of AKI: 29 patients (17.9%) in the ALBC group and 17 (14.7%) in DAIR group developed AKI (odds ratio 1.43; 95% CI 0.70 to 2.93). There was a trend toward increased severity of AKI in the ALBC group. Chronic kidney disease, systemic vancomycin, and diuretic use were independent factors associated with the risk of AKI. An AKI occurred in 17% of PJI patients receiving either a spacer with ALBC or a DAIR. The use of ALBC was not associated with a significant increased risk of AKI. However, the use of systemic vancomycin and diuretic use were independent predictors of AKI in this patient population.
ISSN:0883-5403
1532-8406
DOI:10.1016/j.arth.2023.05.061