SynthesisFrontiers in cellular and infection microbiology2023
Incidence, associated factors, and outcomes of acute kidney injury following placement of antibiotic bone cement spacers in two-stage exchange for periprosthetic joint infection: a comprehensive study.
Synthesis in Frontiers in cellular and infection microbiology, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers, 1 of them a synthesis that pooled it.
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Who cites it
7 citing papers in PubMed, 1 synthesis or guideline pooled it, 6 citations in OpenAlex.
- The application of antibiotic-loaded bone cement in preventing periprosthetic joint infection: an umbrella review.Journal of orthopaedics and traumatology : official journal of the Italian Society of Orthopaedics and Traumatology · 2025Pooled it
- Kidney Injury and Mortality Are Minimal Following Two-Stage Treatment of Periprosthetic Joint Infection.The Journal of arthroplasty · 2026Article
- Research Progress on Risk Factors for Acute Kidney Injury After Antibiotic-Loaded Bone Cement Spacer Treatment for Periprosthetic Joint Infection.Orthopaedic surgery · 2026Review
- Impact of Antibiotic Bone Cement on Infection Rates in Primary Total Knee Arthroplasty: A GRADE-Assessed Systematic Review and Meta-Analysis of Observational Studies Involving Over 4 Million Patients.Open forum infectious diseases · 2026Review
- Dual-antibiotic bone cement (gentamicin + vancomycin) in preventing and treating infections during revision knee arthroplasty in high-risk patients.Journal of experimental orthopaedics · 2026Article
- Hypoalbuminemia is Highly Prevalent in Patients with Periprosthetic Joint Infection and Strongly Associated with Treatment Failure.Orthopaedic surgery · 2024Article
- Single-stage revision in the management of prosthetic joint infections after total knee arthroplasty - A review of current concepts.Journal of clinical orthopaedics and trauma · 2024Article
Corrections and comments
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Authors and funding
8 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Background: Two-stage exchange with placement of antibiotic cement spacer (ACS) is the gold standard for the treatment of chronic periprosthetic joint infection (PJI), but it could cause a high prevalence of acute kidney injury (AKI). However, the results of the current evidence on this topic are too mixed to effectively guide clinical practice. Methods: We retrospectively identified 340 chronic PJI patients who underwent the first-stage exchange with placement of ACS. The Kidney Disease Improving Global Outcomes guideline was used to define postoperative AKI. Multivariate logistic analysis was performed to determine the potential factors associated with AKI. Furthermore, a systematic review and meta-analysis on this topic were conducted to summarize the knowledge in the current literature further. Results: In our cohort, the incidence of AKI following first-stage exchange was 12.1%. Older age (per 10 years, OR= 1.509) and preoperative hypoalbuminemia (OR= 3.593) were independent predictors for postoperative AKI. Eight AKI patients progressed to chronic kidney disease after 90 days. A meta-analysis including a total of 2525 PJI patients showed the incidence of AKI was 16.6%, and AKI requiring acute dialysis was 1.4%. Besides, host characteristics, poor baseline liver function, factors contributing to acute renal blood flow injury, and the use of nephrotoxic drugs may be associated with the development of AKI. However, only a few studies supported an association between antibiotic dose and AKI. Conclusion: AKI occurs in approximately one out of every six PJI patients undergoing first-stage exchange. The pathogenesis of AKI is multifactorial, with hypoalbuminemia could be an overlooked associated factor. Although the need for acute dialysis is uncommon, the fact that some AKI patients will develop CKD still needs to be taken into consideration.
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