Nephrotoxicity and Modern Volatile Anesthetics: A Narrative Review.

IF 3.9 3区环境科学与生态学 Q2 ENVIRONMENTAL SCIENCES

Toxics Pub Date : 2025-06-19 DOI:10.3390/toxics13060514

Benedicte Hauquiert, Aurelien Gonze, Thibault Gennart, Emily Perriens, Sydney Blackman, Nathan De Lissnyder, Arnaud Robert, Julien Moury, Gauthier Nendumba, Ilann Oueslati, Priscilla Gillis, Ovidiu Vornicu, Anne-Sophie Dincq, Pierre Bulpa, Isabelle Michaux, Patrick M Honore

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引用次数: 0

Abstract

Volatile anesthetics, while increasingly utilized in intensive care medicine, are associated with significant renal adverse effects. A critical safety concern-particularly with sevoflurane-involves its potential impact on renal function. Pathophysiologically, inorganic fluoride levels exceeding 50 µmol/L are recognized as a threshold for nephrogenic diabetes insipidus, a condition generally considered reversible. Additionally, the sevoflurane degradation product "compound A" has been implicated in direct renal tubular and glomerular toxicity. Specifically, exposure has been correlated with glomerular damage, evidenced by albuminuria, as well as injury to both proximal and distal tubules, indicated by elevated levels of α-glutathione-S-transferase. Postprandial glycosuria may also be observed. Unlike nephrogenic diabetes insipidus, the structural damage induced by compound A may result in irreversible renal impairment.

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肾毒性与现代挥发性麻醉剂：叙述性回顾。

挥发性麻醉药，虽然越来越多地用于重症监护医学，与显著的肾脏不良反应有关。一个关键的安全问题——尤其是七氟醚——涉及到它对肾功能的潜在影响。病理生理学上，无机氟水平超过50µmol/L被认为是肾源性尿崩症的阈值，这种情况通常被认为是可逆的。此外，七氟醚降解产物“化合物A”与直接肾小管和肾小球毒性有关。具体来说，暴露与肾小球损伤相关，这可以通过蛋白尿来证明，也可以通过α-谷胱甘肽- s转移酶水平升高来证明对近端和远端小管的损伤。餐后也可出现糖尿。与肾源性尿崩症不同，化合物A引起的结构损伤可导致不可逆的肾损害。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Toxics Chemical Engineering-Chemical Health and Safety

CiteScore

4.50

自引率

10.90%

发文量

681

审稿时长

6 weeks

期刊介绍： Toxics (ISSN 2305-6304) is an international, peer-reviewed, open access journal which provides an advanced forum for studies related to all aspects of toxic chemicals and materials. It publishes reviews, regular research papers, and short communications. Our aim is to encourage scientists to publish their experimental and theoretical results in detail. There is, therefore, no restriction on the maximum length of the papers, although authors should write their papers in a clear and concise way. The full experimental details must be provided so that the results can be reproduced. Electronic files or software regarding the full details of calculations and experimental procedure can be deposited as supplementary material, if it is not possible to publish them along with the text.