Microalbuminuria is acutely increased during anesthesia and surgery
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A Mercatello1, A Hadj-Aïssa, C Chery
1Service d'Anesthésie et Réanimation, Hôptial Edouard-Herriot, Lyon, France.
Abstract:
Microalbuminuria is known to increase in various diseases with potential repercussion on the kidneys and indicates an increase in glomerular intracapillary pressure or changes in permeability characteristics. In this study, we measured whether albumin excretion is affected in patients undergoing anesthesia and surgery, which are both known to induce dramatic changes in renal function and in the release of vasoactive substances such as catecholamines, vasopressin, angiotensin, and prostaglandins. Seven patients with normal renal function and physiological microalbuminuria prior to surgery were studied. Urine samples were collected before anesthesia, just before the beginning of surgery, and thereafter 30 min following incision, and 30 min after the end of surgery. Anesthesia induced a significant increase in microalbuminuria, which further increased during surgery. After the end of surgical procedure, microalbuminuria decreased but remained significantly higher than control. This phenomenon may be due to an increase in intracapillary glomerular pressure and/or an alteration in glomerular permeability induced by a direct effect of drugs, or to the action of vasoactive substances on the glomerular structure.
Insights
Anesthesia and surgery significantly increase microalbuminuria (a marker of kidney stress) in patients. Albumin levels rise during procedures and remain elevated post-surgery, indicating potential kidney impact.
Area of Science:
- Nephrology
- Anesthesiology
- Surgical Science
Background:
- Microalbuminuria signifies kidney damage, often linked to increased glomerular pressure or altered permeability.
- Anesthesia and surgery are known to impact renal function and vasoactive substance release.
Purpose of the Study:
- To investigate the effect of anesthesia and surgery on albumin excretion in patients.
- To assess changes in microalbuminuria during and after surgical procedures.
Main Methods:
- Studied seven patients with normal renal function and baseline microalbuminuria.
- Collected urine samples at multiple time points: pre-anesthesia, pre-surgery, 30 min post-incision, and 30 min post-surgery.
Main Results:
- Anesthesia significantly increased microalbuminuria.
- Microalbuminuria further elevated during surgery.
- Post-surgery, albuminuria decreased but remained significantly higher than baseline.
Conclusions:
- Anesthesia and surgery induce a notable increase in microalbuminuria.
- Elevated albuminuria may result from increased glomerular pressure or altered permeability.
- Vasoactive substances released during surgery could affect glomerular structure, contributing to increased albumin excretion.