[Renal effect of isoflurane].

Area of Science:

• Anesthesiology
• Nephrology
• Pharmacology

Context:

• Isoflurane, a widely used inhalation anesthetic, is known to be metabolized to inorganic fluoride.
• Potential nephrotoxicity associated with isoflurane administration necessitates a thorough understanding of its renal effects.
• Evaluating the impact of isoflurane on renal hemodynamics and excretory functions is crucial for patient safety.

Purpose:

• To investigate the effects of isoflurane anesthesia on renal hemodynamic and excretory function in patients.
• To quantify changes in renal plasma flow (RPF) and glomerular filtration rate (GFR) during isoflurane anesthesia.
• To assess the reversibility of isoflurane-induced renal alterations post-anesthesia.

Summary:

• Isoflurane anesthesia led to a slight reduction in systolic blood pressure but did not significantly alter diastolic or mean arterial pressures.
• Significant reductions in renal plasma flow (30%) and glomerular filtration rate (50%) were observed, with a notable increase in filtration fraction.
• Decreased urine flow, sodium excretion, potassium excretion, osmolar clearance, and free water reabsorption occurred during anesthesia, with all parameters returning to baseline within 30-60 minutes post-anesthesia.

Impact:

• The study demonstrates that isoflurane induces a reversible, temporary renal depressive effect.
• Findings highlight the importance of monitoring renal function in patients undergoing isoflurane anesthesia.
• Provides valuable data for anesthesiologists and nephrologists regarding the perioperative renal impact of isoflurane.