Sevoflurane, a volatile halogenated ether, has been widely used in the conduct of anesthesia. Its potency, easy titratability, less pungency and rapid recovery are the reasons for its pervasive use in clinical practice. However, it is not without adverse effects. The nephrotoxicity associated with its use has been the subject of dispute over the years. At present, no highly sensitive renal marker has been the subject of dispute over the years. At present, no highly sensitive renal marker has been utilized to assess renal function. Objective: To compare the effect on renal function as measured by nuclear glomerular filtration rate, serum creatinine, urine protein creatinine ratio, proteinuria and glocosuria of sevoflurane with isoflurane in patients undergoing donor nephrectomy. Study Design and Methods: A randomized comparative study of postoperative renal functions as measured by nuclear glomerular filtration rate, serum creatinine, urine protein creatinine ratio, proteinuria and glucosuria in patients undergoing donor nephrectomies who have received low flow (<1 L/Min) sevoflurane or isoflurane were done. Results: A total of 102 kidney donors met the inclusion criteria. Forty seven subjects (46%) were randomized to receive isoflurane while 55 received sevoflurane (54%). Most subjects were in the third decade of life. There was no statistically significant difference between the two groups in terms of the baseline clinical characteristics. Comparing between the two anesthetic groups, there was no significant difference in terms of serum creatinine, total GFR, nuclear GFR per kidney. There was a statistically higher proportion of patients with urine protein- creatinine ratios of 0.2 and above in the isoflurane group (64% versus 38%) while more patients in the sevoflurane group had ratios above 0.2 (62% versus 36%, p=.045). The type of anesthetic agent was not an independent predictor of increasing serum creatinine, total GFR and urine protein- creatinine ratio and nuclear GFR assessed per kidney. Conclusion: There were no statistical differences noted in measured renal function parameters among patients undergoing donor nephrectomy after low flow sevoflurane compared with isoflurane anesthesia. These results suggest that low flow sevoflurane is as safe as low flow isoflurane and does not alter renal functions in patients for donor nephrectomy.
Human ; SEVOFLURANE ; NEPHRECTOMY ; ANESTHESIA ; ISOFLURANE

Mitochondrial encephalomyopathies are genetic defects affecting the mitochondrial respiratory chain. This case report describes the anesthetic considerations for a patient with mitochondrial disease undergoing renal transplantation. Special risk such as malignant hyperthermia as well as plausible anesthetic technique are addressed. This is the case of a 36 year old female previously diagnosed to have end stage renal disease secondary to chronic glomerulonephritis and mitochondrial disease who presented for renal transplantation. Anesthetic technique was general endotracheal anesthesia under total intravenous anesthesia. To avoid a life threatening sequelae associated with mitochondrial diseases, vigilance towards possible complications was undertaken.
Human ; Female ; Adult ; MITOCHONDRIAL ENCEPHALOMYOPATHIES ; KIDNEY TRANSPLANTATION ; KIDNEY FAILURE, CHRONIC ; MITOCHONDRIAL MYOPATHIES ; MITOCHONDRIAL DISEASES