Renal Function in Patients with High Serum Fluoride Concentrations After Prolonged Sevoflurane Anesthesia

Biological indices of kidney involvement in personnel exposed to sevoflurane in surgical areas

“…Patients treated with low-flow SEV showed urinary increases in TUP, NAG, and b 2 -microglobulin [Higuchi et al, 1995], whereas probenecid prevented these effects. Higuchi et al [1995] also observed a reduction in the maximum capability to concentrate urine and an increase in urinary NAG; these data were later supported [Higuchi et al, 1998].…”

“…Conversely, conflicting conclusions are reported in studies performed on patients and volunteers: transient injury to glomeruli (with albuminuria), and in proximal (with glycosuria and increase in a-glutathione-S-transferase in urine) and distal tubules (with increase of p-glutathione-Stransferase in urine) was observed [Eger et al, 1997a]; these effects appeared to increase with duration of exposure [Eger et al, 1997b]. Patients treated with low-flow SEV showed urinary increases in TUP, NAG, and b 2 -microglobulin [Higuchi et al, 1995], whereas probenecid prevented these effects. Higuchi et al [1995] also observed a reduction in the maximum capability to concentrate urine and an increase in urinary NAG; these data were later supported [Higuchi et al, 1998].…”

“…Much interest has been aroused as regards renal effects. There are two possible causes of renal damage: F À ion formation [Higuchi et al, 1995] and, during anesthesia in semi-closed circuit, the formation of fluoromethyl 2,2-difluoro-1-(trifluoromethyl)vinyl ether called Compound A .…”

Rhabdomyolysis following laparoscopic radical nephrectomy: A case to heighten awareness

“…Previous reports have suggested no sevoflurane nephrotoxicity despite increases in serum fluoride concentration after prolonged anaesthesia. 11,12 Hara et al measured urinary Nacetly-β-glucosamine as a non-invasive marker of renal tubular damage. 13 They found a temporary reversible increase in urinary N-acetly-β-glucosamine following 120 min of hypotensive anaesthesia (MAP 60 mmHg) with sevoflurane in patients having no preoperative renal dysfunction.…”

Alterations in the biochemical markers of renal function after sevoflurane anaesthesia

“…type of operation, duration of oper-ation, antibiotics, intraoperative blood pressure, previous renal dysfunction, and surgical stress among others). 8,9,11,20,24 Accordingly, Ebert et al . 25 compared renal responses after anaesthesia with desflurane (negligible metabolism), sevoflurane or intravenous propofol and reported that alterations in postoperative renal function were common and unrelated to the choice of anaesthetic.…”