Nephrotoxic effect of methoxyflurane anesthesia. A case report

Area of Science:

• Anesthesiology
• Nephrology
• Toxicology

Background:

• Methoxyflurane is an inhalational anesthetic agent.
• Routine anesthesia involves exposure to anesthetic agents.
• Patient presented with normal preoperative hepatic and renal function tests.

Observation:

• Patient received low concentrations of methoxyflurane during anesthesia.
• Postoperatively, patient exhibited elevated inorganic serum fluoride levels for 12 days.
• Increased urinary excretion of fluoride and oxalic acid was noted.

Findings:

• Despite elevated fluoride and oxalate, the patient showed no clinical signs of nephrotoxicity.
• This suggests a potential dissociation between biochemical markers and clinical presentation of kidney injury.
• The patient's response indicates a possible low threshold for methoxyflurane-induced nephrotoxicity.

Implications:

• Highlights the importance of monitoring renal function post-methoxyflurane exposure.
• Suggests that 'normal' renal function may not always predict resistance to anesthetic-related toxicity.
• Warrants further investigation into individual patient susceptibility to anesthetic nephrotoxicity.