Читать книгу Manual of Equine Anesthesia and Analgesia - Группа авторов - Страница 301

 Virtually all anesthetic drugs modulate RBF and GFR by direct and indirect effects.GFR is likely to be reduced due to decreased RBF.The ability to excrete sodium is reduced. This is thought to be a result of inhibition of Na/K‐ATPase.Urine volume is usually decreased.

 A number of factors are involved in initiating anesthetic‐induced changes in renal function, and the contribution of each factor is primarily dependent on the horse's physiologic state and the anesthetic regimen. Factors include:Decreases in cardiac output and arterial blood pressure.Increases in sympathetic outflow from renal nerves.Activation of the RAAS.Increased release of ADH.Direct renal effects of anesthetics.

 Many drugs (or metabolites) have some degree of renal metabolism and/or excretion.Renal dysfunction may, in theory, prolong the effects of anesthetic drugs, but this is rarely of clinical importance.

Comment: It is important to consider the co‐morbidities associated with renal disease (e.g. azotemia, acid–base imbalance, electrolyte imbalance, anemia, coagulopathy, hypertension) when determining an anesthetic protocol.