Alterations in the biochemical markers of renal function after sevoflurane anaesthesia

Şekeroğlu, Mehmet Ramazan; Katı, İsmail; Noyan, Tevfik; Dülger, Haluk; Yalçınkaya, Ahmet

doi:10.1111/j.1440-1797.2005.00495.x

Cited by 5 publications

(3 citation statements)

References 38 publications

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“…Published human studies include antibiotics (20,79), cyclosporin (94,95), contrast media (80), and anaesthetics (94,96,97). As a general rule, specific biomarkers are released in advance of changes in serum creatinine.…”

Section: Animal Studiesmentioning

confidence: 99%

Cell-Specific Biomarkers in Renal Medicine and Research

Shaw¹

2010

Methods in Molecular Biology

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Histopathology is the gold standard for defining renal injury, but it is invasive, time-consuming and expensive, plus it is seldom used in subjects with mild renal injury. Using biomarkers linked to distinct, defined cell types and tissues provides a direct link to histopathology without its drawbacks, plus it provides increased sensitivity, and specificity. The nephron consists of several sections, each with its own specific biomarkers; therefore, by the use of a battery of tests injuries can be localised to distinct areas of it. Using urine samples simplifies repeated sampling from the same subject or animal leading to better defined toxicokinetics and disease monitoring.Serum creatinine is the most widely used renal biomarker in spite of its known shortcomings. Cell-specific biomarkers are more specific and sensitive and have been known for over 40 years, but they are still underused in renal medicine and research. In particular, while many studies have shown cell-specific biomarkers to be valuable in diagnosis, there are few studies where they have been used to guide therapy or linked to quantitative changes in the kidney. Furthermore, the great majority of cell-specific biomarkers are from the proximal tubule, which may have hindered research into the study of conditions where the distal tubules are affected. Recently, the range of biomarkers and their applications has been expanded by the introduction of indicators of cellular regeneration.This chapter will discuss how using biomarkers with a known cellular origin, renal effects may be found earlier and at lower levels of injury. Their use in both renal medicine and drug research will be presented. Knowledge of these existing markers lays the foundation for evaluation, comparison, and characterisation of new markers that will be identified in the future.

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Section: Animal Studiesmentioning

confidence: 99%

Cell-Specific Biomarkers in Renal Medicine and Research

Shaw¹

2010

Methods in Molecular Biology

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“…Generally, anesthetics reduce urine output, GFR, renal blood flow, and excretion of electrolytes. Acute alteration of renal function has been reported after use of sevoflurane, 8 but other authors have reported no changes in renal function.…”

Section: Discussionmentioning

confidence: 93%

Postoperative acute renal failure in patients with gynecologic malignancies: analysis of 10 cases and review of the literature

et al. 2009

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Objective: Postoperative acute renal failure (PO-ARF) is an important cause of mortality among surgical patients. Although there have been many reports on PO-ARF after cardiac surgery and liver transplantation, less is known about the risk of PO-ARF after gynecologic operations. We aimed to investigate the risk of PO-ARF on gynecologic malignancy operations. Methods: 1,155 patients' medical charts were reviewed who underwent therapeutic surgery for gynecologic malignancies from January 1, 2005 to December 31, 2007, at the Asan Medical Center, Seoul, Korea. Results: Of these, 10 patients, comprising 0.89% of those who underwent radical hysterectomies and 0.86% of those who underwent debulking operations, were diagnosed with PO-ARF. Their mean age was 61.9±10.1 years. Five patients had preoperative risk factors. Mean operating time was 360.8±96.2 minutes. Five patients experienced intra-operative hypotension and all patients were given blood transfusions during surgery. Eight patients underwent hemodialysis, with two continuing on dialysis to date. Only two patients fully recovered. Conclusion: Patients undergoing surgery for gynecologic malignancies may be at high risk for PO-ARF, because of old age, long operation times, and profuse bleeding. It is necessary to monitor these patients for postoperative renal function and urine output. If a postoperative oliguric state is detected, aggressive volume expansion should be started immediately, followed by hemodialysis.

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“…Lee et al 22 demonstrated the anti-inflammatory and anti-necrotic effects of sevoflurane in cultured kidney proximal tubule cells and probed the mechanism of sevoflurane-induced renal cell protection. Similarly,Şekeroglu et al 23 found out that although there is an acute altering in renal glomerular function with sevoflurane, this does not have a significant effect on biochemical markers of renal tubular damage. In another randomized study comparing sevoflurane and halothane anesthesia in infants and children with congenital heart disease, sevoflurane had hemodynamic advantages over halothane.…”

Section: Time Groupsmentioning

confidence: 99%

The Effects of Sevoflurane Anesthesia and Cardiopulmonary Bypass on Renal Function in Cyanotic and Acyanotic Children Undergoing Cardiac Surgery

Akıncı

Kanbak

et al. 2011

Renal Failure

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Background: There are few data on the effects of anesthesia and cardiopulmonary bypass (CPB) on perioperative renal function in children with cyanotic congenital heart disease undergoing open heart surgery. This study aims to investigate the perioperative renal function in cyanotic versus acyanotic children undergoing sevoflurane anesthesia for open heart surgery. Methods: After receiving ethical committee approval, 12 acyanotic patients (preoperative oxygen saturation: SaO 2 > 85%) and 12 cyanotic children (SaO 2 < 85%) were included. Sevoflurane was administered at concentration levels of 2% before CPB and 1-2% during CPB after standard anesthesia induction. Inorganic fluoride, electrolytes, creatinine, urea nitrogen in serum and urine samples, and N-acetyl-β-D-glucosaminidase (NAG) in urine samples were measured before induction, before CPB, during CPB, after CPB, at the end of surgery, and at 24th h postoperatively. Results: The levels of serum uric acid levels were higher in the cyanotic group (p < 0.05). There were no differences in the levels of serum creatinine and urine creatinine, urea nitrogen, and electrolytes between the two groups. Serum inorganic fluoride levels were always higher in the acyanotic group than in the cyanotic group, but these differences between the groups reached statistical significance at two measurement times (before CPB and end of surgery) (p < 0.05). Urinary inorganic fluoride levels increased with time in both groups. Although urinary NAG increased significantly after the CPB in the cyanotic group, the differences between the two groups did not reach statistical significance. Conclusions: We have concluded that renal function was not affected during open heart surgery with sevoflurane anesthesia, in both cyanotic and acyanotic children.

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Alterations in the biochemical markers of renal function after sevoflurane anaesthesia

Abstract: These results suggest that a 2% end-tidal concentration of sevoflurane at a high flow-rate (6 L/min) acutely alters renal glomerular function but does not have a significant acute effect on biochemical markers of renal tubular damage.

Cited by 5 publications

References 38 publications

Cell-Specific Biomarkers in Renal Medicine and Research

Cell-Specific Biomarkers in Renal Medicine and Research

Postoperative acute renal failure in patients with gynecologic malignancies: analysis of 10 cases and review of the literature

The Effects of Sevoflurane Anesthesia and Cardiopulmonary Bypass on Renal Function in Cyanotic and Acyanotic Children Undergoing Cardiac Surgery

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