Question:medium
Which inhalational anaesthetic agent is contraindicated in renal failure?
Which inhalational anaesthetic agent is contraindicated in renal failure?
Show Hint
Think of the volatile agent whose extensive metabolism releases nephrotoxic fluoride.
Updated On: Jun 24, 2026
- Isoflurane
- Desflurane
- Halothane
- Methoxyflurane
Show Solution
The Correct Option is D
Solution and Explanation
Step 1: Renal safety of a volatile agent depends on how much it is broken down to fluoride. The greater the fluoride load, the higher the risk to the kidney.
Step 2: Rank the agents by metabolism. Desflurane is almost inert, isoflurane is minimally metabolised, and halothane is metabolised to a modest degree but causes hepatic rather than fluoride-related renal injury. Methoxyflurane sits at the extreme end, being very extensively metabolised.
Step 3: Its breakdown, including metabolism within the kidney itself, liberates inorganic fluoride that injures the renal tubules. The result is a characteristic high-output renal failure, and the drug is also associated with hepatotoxicity.
Step 4: For this reason methoxyflurane is the agent to avoid in renal failure, while the other three remain acceptable from a renal standpoint.
\[\boxed{\text{Methoxyflurane}}\]
Step 2: Rank the agents by metabolism. Desflurane is almost inert, isoflurane is minimally metabolised, and halothane is metabolised to a modest degree but causes hepatic rather than fluoride-related renal injury. Methoxyflurane sits at the extreme end, being very extensively metabolised.
Step 3: Its breakdown, including metabolism within the kidney itself, liberates inorganic fluoride that injures the renal tubules. The result is a characteristic high-output renal failure, and the drug is also associated with hepatotoxicity.
Step 4: For this reason methoxyflurane is the agent to avoid in renal failure, while the other three remain acceptable from a renal standpoint.
\[\boxed{\text{Methoxyflurane}}\]
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