THE EFFECTS OF SEVOFLURANE AND ISOFLURANE ANESTHESIA ON RENAL TUBULARFUNCTION IN PATIENTS WITH MODERATELY IMPAIRED RENAL-FUNCTION

Increasing evidence indicates that sevoflurane anesthesia does not imp air renal function in healthy patients despite higher concentrations o f plasma inorganic fluoride. However, whether sevoflurane further affe cts renal tubular function in patients with impaired renal function is not known. We compared the effect of sevoflurane anesthesia with that of isoflurane anesthesia on renal tubular function in patients with m oderately impaired renal function. Fourteen patients with creatinine c learance between 10 and 55 mL/min were anesthetized with either sevofl urane or isoflurane using a semiclosed circuit system. Plasma inorgani c fluoride concentrations and urine N-acetyl-beta-D-glucosaminidase (N AG), gamma-glutamyltranspeptidase (gamma-GTP), and beta(2)-microglobul in (beta(2)MG) excretions were measured up to post-anesthetic day 14. Although both the peak plasma inorganic fluoride concentrations and th e areas under the curve of plasma inorganic fluoride concentration ver sus time were significantly greater in the sevoflurane group than in t he isoflurane group, urine NAG, gamma-GTP, and beta(2)MG excretions pe r day did not differ between the two groups. These results indicate th at sevoflurane and isoflurane may have similar effects on the renal tu bules in patients with moderately impaired renal function.