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ARTICLE |

Interstitial Fibrosis and Chronic Renal Failure Following Methoxyflurane Anesthesia

Benjamin A. Halpren, MD; Richard L. Kempson, MD; Norman S. Coplon, MD
JAMA. 1973;223(11):1239-1242. doi:10.1001/jama.1973.03220110021006.
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Methoxyflurane (Penthrane) has been shown to cause acute polyuric renal failure. Two patients recently manifested typical polyuric renal failure for two to three days following abdominal surgery with the use of methoxyflurane anesthesia. However, they then developed oliguric renal failure, requiring hemodialysis. Both showed x-ray film evidence of shrinkage of renal mass. The mean length of the renal silhouettes decreased from 13.5 to 11.3 cm in one patient and from 12.5 to 10.9 cm in the other. Renal biopsy in each patient disclosed intratubular and intertubular calcium oxalate crystal deposition and severe interstitial fibrosis. A second biopsy and autopsy in one patient demonstrated progression of the fibrosis. The latter patient died 14 months after surgery while undergoing chronic dialysis. The other patient no longer requires dialysis and has a serum creatinine level of 8 mg/100 ml.

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The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
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