A Comparison of Kidney Function After Nephrectomy in Living Donors Under Sevoflurane and Desflurane Anesthesia
Status:
Completed
Trial end date:
2012-10-01
Target enrollment:
Participant gender:
Summary
Living-donor kidney transplantation has been considered as the best treatment for patients
with end-stage renal disease (ESRD). Kidney donation from living donors has been performed
widely under their noble humanity and a belief that donation would not harm the donor.
Although the overall evidences proposed that living kidney donor have medical outcomes
similar to those in general population, several reports have demonstrated the potential risks
for development of hypertension, proteinuria, and ESRD. Thus, all efforts should be
concentrated on ensuring their safety and preserving the function of their remained kidney
during anesthesia maintenance.
Inhaled anesthetics have been frequently used for the induction and maintenance of general
anesthesia. The metabolism of certain inhaled anesthetics can produce inorganic fluoride,
which may be directly nephrotoxic through impairments of renal concentrating ability. The
typical inhaled anesthetics commonly used nowadays are sevoflurane and desflurane. The
defluorination of sevoflurane can results in increased serum inorganic fluoride ion
concentrations, but any neprhotoxic effect of sevoflurane has not been proven yet in human.
On the other hand, desflurane is extremely resistant to defluorination, and desflurane does
not appear to be nephrotoxic.
The inhaled anesthetics which are currently used in general anesthesia have no clinical
evidence of nephrotoxicity, but the possible risks cannot be excluded entirely, especially in
the patients who one kidney is donated. The purpose of the current retrospective, single
center study was to evaluate and compare postoperative renal function of living kidney donor
after nephrectomy under sevoflurane or desflurane anesthesia, and make evidence-based
recommendations of proper inhaled anesthetics for anesthesia of living kidney donor.