Alterations in the biochemical markers of renal function after sevoflurane anaesthesia.
OBJECTIVE
This study has been carried out to see whether renal function is acutely altered in patients undergoing sevoflurane anaesthesia. For this purpose, the urinary levels of markers of renal tubular function, namely leucine amino peptidase (LAP), gamma-glutamyl transferase (GGT), alkaline phosphatase (ALP), lactate dehydrogenase (LDH) and beta-2 microglobulin (beta-2M), and urinary albumin as a predictor of renal glomerular function were measured before and after sevoflurane anaesthesia.


METHODS
This study was comprised of 20 patients (11 males and nine females) aged 18-55, who underwent various elective surgical procedures under general anaesthesia. Urine samples of all patients were collected before and 1, 2 and 8 h after the anaesthesia. The levels of LAP, GGT, beta-2M, and albumin were then expressed as factored by urinary creatinine. In all patients, the anaesthesia was maintained with sevoflurane (2% end-tidal) at a high flow-rate (6 L/min).


RESULTS
Urinary beta-2M and LAP levels after anaesthesia were unchanged (P > 0.05). While urinary GGT and ALP levels were found elevated in the first hour, LDH levels were higher in the second hour (P < 0.05). They returned to normal levels in the later periods after the anaesthesia. Urinary albumin excretion (UAE) was significantly elevated in the second hour after the anaesthesia (P < 0.001). Although UAE was decreased in the eighth hour after the anaesthesia, it still remained higher than the pre-anaesthesia level (P < 0.001).


CONCLUSIONS
These results suggest that a 2% end-tidal concentration of sevoflurane at a high flow-rate (6 L/min) acutely alters renal glomerular function but does not have a significant acute effect on biochemical markers of renal tubular damage.
Sekeroğlu
Mehmet R
MR
Department of Biochemistry, School of Medicine, Yüzüncü Yil University, Van, Turkey. mrseker@yyu.edu.tr
Kati
Ismail
I
Noyan
Tevfik
T
Dülger
Haluk
H
Yalçinkaya
Ahmet S
AS
D000293:Adolescent; D000328:Adult; D000469:Alkaline Phosphatase / Q000652:urine; D000769:Anesthesia, Inhalation; D018685:Anesthetics, Inhalation / Q000494:pharmacology*; D005260:Female; D006801:Humans; D007668:Kidney / Q000187:drug effects / Q000502:physiology*; D007770:L-Lactate Dehydrogenase / Q000652:urine; D007931:Leucyl Aminopeptidase / Q000652:urine; D008297:Male; D008738:Methyl Ethers / Q000494:pharmacology*; D008875:Middle Aged; D000077149:Sevoflurane; D001613:beta 2-Microglobulin / Q000652:urine; D005723:gamma-Glutamyltransferase / Q000652:urine
D018685:Anesthetics, Inhalation; D008738:Methyl Ethers; D001613:beta 2-Microglobulin; D000077149:Sevoflurane; D007770:L-Lactate Dehydrogenase; D005723:gamma-Glutamyltransferase; D000469:Alkaline Phosphatase; D007931:Leucyl Aminopeptidase