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[Changes in renal function induced by anesthesia].

A Mercatello1

  • 1Service d'Anesthésie et de Réanimation, Hôpital Edouard-Herriot, Lyon.

Annales Francaises D'Anesthesie Et De Reanimation
|January 1, 1990
PubMed
Summary
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Anesthetics and surgical stress significantly impact kidney function, affecting urine production and composition. Proper perioperative management is crucial to minimize the risk of acute renal failure (ARF).

Area of Science:

  • Nephrology and Anesthesiology
  • Renal physiology and pharmacology

Context:

  • Surgical procedures involve various anesthetic agents and physiological stressors that can profoundly influence renal function.
  • Understanding these effects is critical for managing patients perioperatively and preventing kidney injury.

Purpose:

  • To review the impact of anesthetics, surgical stress, and perioperative management on renal function, including urine formation and composition.
  • To highlight the mechanisms by which these factors affect the kidney, such as hemodynamic changes and neuroendocrine activity.
  • To discuss the implications for the development of acute renal failure (ARF).

Summary:

  • Anesthetics can alter renal blood flow (RBF) and glomerular filtration rate (GFR), with effects varying by drug class (e.g., barbiturates, inhalational agents, opioids).

Related Experiment Videos

  • Surgical stress induces hemodynamic changes and neuroendocrine responses (e.g., increased catecholamines, angiotensin, vasopressin) that impact renal perfusion and function.
  • Factors like mechanical ventilation with positive end-expiratory pressure and pre-existing conditions can exacerbate renal dysfunction. Perioperative fluid management and monitoring are essential.
  • Impact:

    • Provides a comprehensive overview of anesthetic and surgical influences on kidney function, aiding clinicians in patient care.
    • Emphasizes the importance of proactive management strategies to mitigate the risk of perioperative acute renal failure (ARF).
    • Contributes to the body of knowledge on renal physiology under stress, informing future research and clinical guidelines.