Differential protective effects of volatile anesthetics against renal ischemia-reperfusion injury in vivo

H. Thomas Lee, Ayuko Ota-Setlik, Yulei Fu, Samih H. Nasr, Charles W. Emala

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Abstract

Background: Volatile anesthetics protect against cardiac ischemia-reperfusion injury via adenosine triphosphate-dependent potassium channel activation. The authors questioned whether volatile anesthetics can also protect against renal ischemia-reperfusion injury and, if so, whether cellular adenosine triphosphate-dependent potassium channels, antiinflammatory effects of volatile anesthetics, or both are involved. Methods: Rats were anesthetized with equipotent doses of volatile anesthetics (desflurane, halothane, isoflurane, or sevoflurane) or injectable anesthetics (pentobarbital or ketamine) and subjected to 45 min of renal ischemia and 3 h of reperfusion during anesthesia. Results: Rats treated with volatile anesthetics had lower plasma creatinine and reduced renal necrosis 24-72 h after injury compared with rats anesthetized with pentobarbital or ketamine. Twenty-four hours after injury, sevoflurane-, isoflurane-, or halothane-treated rats had creatinine (± SD) of 2.3 ± 0.7 mg/dl (n = 12), 1.8 ± 0.5 mg/dl (n = 6), and 2.4 ± 1.2 mg/dl (n = 6), respectively, compared with rats treated with pentobarbital (5.8 ± 1.2 mg/dl, n = 9) or ketamine (4.6 ± 1.2 mg/dl, n = 8). Among the volatile anesthetics, desflurane demonstrated the least reduction in plasma creatinine after 24 h (4.1 ± 0.8 mg/dl, n = 12). Renal cortices from volatile anesthetic-treated rats demonstrated reduced expression of intercellular adhesion molecule 1 protein and messenger RNA as well as messenger RNAs encoding proinflammatory cytokines and chemokines. Volatile anesthetic treatment reduced renal cortex myeloperoxidase activity and reduced nuclear translocation of proinflammatory nuclear factor κB. Adenosine triphosphate-dependent potassium channels are not involved in sevoflurane-mediated renal protection because glibenclamide did not block renal protection (creatinine: 2.4 ± 0.4 mg/dl, n = 3). Conclusion: Some volatile anesthetics confer profound protection against renal ischemia-reperfusion injury compared with pentobarbital or ketamine anesthesia by attenuating inflammation. These findings may have significant clinical implications for anesthesiologists regarding the choice of volatile anesthetic agents in patients subjected to perioperative renal ischemia.

Original languageEnglish (US)
Pages (from-to)1313-1324
Number of pages12
JournalAnesthesiology
Volume101
Issue number6
StatePublished - Dec 2004
Externally publishedYes

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Reperfusion Injury
Anesthetics
Kidney
Ketamine
Pentobarbital
Potassium Channels
Creatinine
Adenosine Triphosphate
Isoflurane
Halothane
Ischemia
Anesthesia
Messenger RNA
Glyburide
Wounds and Injuries
Intercellular Adhesion Molecule-1
Chemokines
Peroxidase
Reperfusion
Anti-Inflammatory Agents

ASJC Scopus subject areas

  • Anesthesiology and Pain Medicine

Cite this

Lee, H. T., Ota-Setlik, A., Fu, Y., Nasr, S. H., & Emala, C. W. (2004). Differential protective effects of volatile anesthetics against renal ischemia-reperfusion injury in vivo. Anesthesiology, 101(6), 1313-1324.

Differential protective effects of volatile anesthetics against renal ischemia-reperfusion injury in vivo. / Lee, H. Thomas; Ota-Setlik, Ayuko; Fu, Yulei; Nasr, Samih H.; Emala, Charles W.

In: Anesthesiology, Vol. 101, No. 6, 12.2004, p. 1313-1324.

Research output: Contribution to journalArticle

Lee, HT, Ota-Setlik, A, Fu, Y, Nasr, SH & Emala, CW 2004, 'Differential protective effects of volatile anesthetics against renal ischemia-reperfusion injury in vivo', Anesthesiology, vol. 101, no. 6, pp. 1313-1324.
Lee, H. Thomas ; Ota-Setlik, Ayuko ; Fu, Yulei ; Nasr, Samih H. ; Emala, Charles W. / Differential protective effects of volatile anesthetics against renal ischemia-reperfusion injury in vivo. In: Anesthesiology. 2004 ; Vol. 101, No. 6. pp. 1313-1324.
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