Some of the halogenated inhalation anesthetics are metabolized partly in the liver to produce inorganic fluoride, and serum inorganic fluoride in continuous high concentration may cause renal dysfunction. In this study, the influence of elevated serum inorganic fluoride concentration and the duration of its action on renal function were studied by continuous infusion of sodium fluoride in rabbits for 24hours.
The rabbits were divided into Control (
group C), Low dose (
group L) and High dose (
group H) groups with mean serum inorganic fluoride levels of 1.9 μM, 62.4 μM and 237.7 μM, respectively. Twenty-four hour total urine volume increased in
group H compared to
group C. Urinary excretion of β
2-microglobulin (β
2MG), leucine aminopeptidase (LAP) and N-acetyl-β-D-glucosaminidase (NAG), collected every 6 hours, increased significantly in
group H within 06 hours, whereas LAP increased within 1824 hours and NAG within 1218 hours in
group L, compared to
group C. The area under the curve of serum inorganic fluoride concentration, when the increase of NAG (the earliest among β
2MG, LAP and NAG) excretion was detected (6 hours in
group H, 18 hours in
group L), were similar (
group H; 1272±165 μM·hours,
group L; 1197±189 μM·hours). Free water clearance over 24 hours increased significantly in
group H only. Morphological examination showed the absence of the brush border and that cellular damage had occurred in the renal tubules in both
group L and
group H. These findings were more apparent in
group H.In conclusion, it was revealed that not only the elevated serum inorganic fluoride concentration but also its duration were the factors inducing renal dysfunction, beginning with proximal tubuar damage and subsequently developing to decreased water reabsorption.
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