Detection of Renal Dysfunction during and after Anesthesia and Surgery: Evaluation of the Influence of Inorganic Fluoride, Ketorolac and Clonidine

..................................................................................................................... 5 ACKNOWLEDGEMENTS .............................................................................................. 9 ABBREVIATIONS ........................................................................................................... LIST OF ORIGINAL PUBLICATIONS ........................................................................... INTRODUCTION ............................................................................................................. 9 REVIEW OF THE LITERATURE .................................................................................... 2 Kidney and renal function ........................................................................................... 2 Acute renal failure ....................................................................................................... 22 Impact of hypovolemia on renal function.................................................................... 2 Biomarkers of renal function ....................................................................................... 2 Traditional biomarkers ........................................................................................... 2 Creatinine ......................................................................................................... 2 Creatinine clearance ........................................................................................ 2 Urea .................................................................................................................. 25 Novel biomarkers ................................................................................................... 25 Cystatin C ......................................................................................................... 25 α1-microglobulin .............................................................................................. 25 N-acetyl-β-D-glucosaminidase ......................................................................... 27 β2-microglobulin .............................................................................................. 27 Glutathione-S-transferase – α and – π ............................................................. 27 Tumor associated trypsin inhibitor ................................................................... 28 Plasma renin activity ........................................................................................ 28 Sevoflurane .................................................................................................................. 29 Metabolism of sevoflurane ..................................................................................... 29 Compound A ......................................................................................................... 29 Sevoflurane anesthesia and renal markers.............................................................. 0 N-acetyl-β-D-glucosaminidase ......................................................................... 0 β2-microglobulin .............................................................................................. 0 Glutathione transferase-α and -π ..................................................................... 0 Enflurane ..................................................................................................................... 2 Metabolism of enflurane ........................................................................................ 2 Inorganic fluoride formed in the metabolism of enflurane and sevoflurane and renal function ................................................................................................................... 2 Nonsteroidal anti-inflammatory analgesic drugs ......................................................... Nonsteroidal anti-inflammatory drugs and renal function .................................... Ketorolac................................................................................................................ Clonidine ....................................................................................................................... 5 Clonidine and renal function .................................................................................. 6 Circulatory effects of carbon dioxide pneumoperitoneum .......................................... 6 Carbon dioxide pneumoperitoneum and renal function .......................................... 6