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[Kidney function in test subjects: published results and clinical relevance]
1Department of Anesthesiology, University of Arizona Health Sciences Center, Tucson 85724-5114, USA.
Der Anaesthesist
|January 20, 1999
Summary
Sevoflurane degradation in CO2 absorbents can produce Compound A. Studies in volunteers suggest sevoflurane anesthesia, especially low-flow, has minimal impact on renal function, similar to isoflurane.
Area of Science:
- Anesthesiology
- Toxicology
- Nephrology
Background:
- Sevoflurane can degrade in CO2 absorbents, forming Compound A.
- Compound A has potential hepatotoxic effects in humans.
- Previous studies yielded conflicting results regarding Compound A's renal impact.
Purpose of the Study:
- To evaluate the potential renal toxicity of sevoflurane in human volunteers.
- To assess the impact of varying sevoflurane administration protocols on renal markers.
- To compare renal function after sevoflurane anesthesia with isoflurane.
Main Methods:
- Human volunteers received sevoflurane anesthesia at 3% concentration for 8 hours at 2 L/min flow.
- A separate study used 3% sevoflurane for 4 hours at 1 L/min flow.
- Urine samples were analyzed for protein, glucose, and renal tubular enzymes.
Main Results:
- Initial 8-hour studies showed high excretion of urinary markers.
- Subsequent identical 8-hour studies revealed minor or absent changes in these markers.
- The 4-hour low-flow study demonstrated no significant changes in urinary markers.
Conclusions:
- Results from volunteer studies indicate variability in renal marker excretion.
- Low-flow sevoflurane anesthesia for modest durations appears to have minimal renal impact.
- Renal function post-low-flow sevoflurane anesthesia is comparable to isoflurane anesthesia.