Theil C, Riegel RF, Gosheger G, et al. - Given that acute kidney injury (AKIN) can develop as a systemic complication of two-stage exchange using antibiotic-loaded spacers, which is a common approach in treating periprosthetic joint infections, therefore, researchers undertook this single-center retrospective study to unveil the risk factors. Participants were patients receiving 2-stage exchange using a spacer in 285 patients managed between 2010 and 2017. Postoperatively, AKIN development was seen in 33% of patients (95/285). Risk factors for AKIN, as revealed in multivariate analysis, were a higher age and a higher baseline creatinine level. A higher median Charlson comorbidity index, a lower preoperative hemoglobin, and a higher number of blood transfusions were shown to be related to AKIN in univariate analysis. Overall, patients undergoing 2-stage exchange commonly developed AKIN. Optimizing associated patient factors, especially in patients with chronic renal dysfunction, was recommended. No risk for AKIN was conferred by the general use of glycopeptide antibiotics.