Mild or moderate renal insufficiency does not increase circulating levels of cobalt and chromium in patients with metal-on-metal hip arthroplasty

Aims

To determine whether there is any association between glomerular filtration rate (GFR) and blood cobalt (Co) and chromium (Cr) levels in patients with metal-on-metal (MoM) hip arthroplasty.

Patients and Methods

We identified 179 patients with a unilateral 36 mm diameter head as part of a stemmed Summit-Pinnacle MoM hip arthroplasty. GFR was calculated using the Modification of Diet in Renal Disease formula.

Results

Normal renal function (GFR ≥ 90 ml/min/1.73 m²) was seen in 74 patients. Mild renal insufficiency (GFR 60 to 89 ml/min/1.73 m²) was seen in 90 patients and moderate renal insufficiency (GFR 30 to 59 ml/min/1.73 m²) in 15. There was no statistical difference in Co and Cr levels between patients with normal renal function and those with mild or moderate renal insufficiency. No correlation was seen between creatinine and blood metal ion levels or between GFR and blood metal ion levels. Linear regression analysis did not show any association between Co and Cr levels and GFR.

Conclusion

We did not find any association between GFR and blood metal ion levels. Consequently, the accumulation of Co and Cr in blood due to renal insufficiency does not seem to be a major risk in patients with mild or moderate renal insufficiency.

Cite this article Bone Joint J 2017;99-B:1147–52