Miklić Bublić Martina, Tonković Dinko, Sakan Sanja, Misir Anita, Bandić Pavlović Daniela
University Department of Anesthesiology, Resuscitation and Intensive Care, Zagreb University Hospital Center, Zagreb, Croatia
University of Zagreb, School of Medicine, Zagreb, Croatia
Acta Clin Croat. 2016 Sep;55(3):464-468. doi: 10.20471/acc.2016.55.03.16.
Acute kidney injury (AKI) is a serious complication associated with increased morbidity and mortality. Total incidence of AKI in hospitalized patients is 1%-5%. As many as 30% of these patients develop AKI in the perioperative period, which is associated with anesthesia and surgery. Despite scientific advances and improved surgery techniques, as well as treatment in intensive care units, no significant decrease in AKI incidence has been achieved. To change this outcome, it is important to identify patients at risk of AKI and prevent its occurrence. Correct selection of anesthetic drugs during general anesthesia, adjusted to the individual needs of patients, also influences the overall outcome of treatment. Nowadays, inhalational anesthetics are not considered nephrotoxic. The more so, inhalational anesthetics have a strong and direct protective effect on many organs through preconditioning and postconditioning. New studies have shown that sevoflurane diminishes ischemia/ reperfusion kidney injury and has an anti-inflammatory effect, thus having the potential to reduce the occurrence of AKI. Given the incidence of AKI in the perioperative period, as well as new findings about anesthetics, the issue of anesthetic selection during general anesthesia might be of crucial importance for the final outcome of treatment.
急性肾损伤（AKI）是一种严重并发症，与发病率和死亡率增加相关。住院患者中AKI的总发病率为1%-5%。其中多达30%的患者在围手术期发生AKI，这与麻醉和手术有关。尽管有科学进展、手术技术改进以及重症监护病房的治疗，但AKI的发病率并未显著降低。为改变这一结果，识别有AKI风险的患者并预防其发生很重要。全身麻醉期间根据患者个体需求正确选择麻醉药物也会影响治疗的总体结果。如今，吸入性麻醉剂不被认为具有肾毒性。更重要的是，吸入性麻醉剂通过预处理和后处理对许多器官具有强大而直接的保护作用。新研究表明，七氟醚可减轻缺血/再灌注肾损伤并具有抗炎作用，因此有可能减少AKI的发生。鉴于围手术期AKI的发病率以及关于麻醉剂的新发现，全身麻醉期间的麻醉剂选择问题可能对治疗的最终结果至关重要。
