Despite the well-documented oliguria associated with laparoscopy, acute renal failure following laparoscopy, in the absence of another obvious etiology, is rare.
However, in one 67-year-old man with chronic renal insufficiency, renal tubular acidosis, and hypertension, renal failure lasted for two weeks following laparoscopy (175). The effect of laparoscopy on kidney function is transient, with renal indices returning almost to baseline within two hours of the release of pneumoperitoneum (68). This has been shown to be the case even in a high-risk renal insufficiency model (176). The adverse effects of nephrotoxic agents such as aminoglycosides are not worsened by laparoscopy (177).
If acute renal failure does occur after laparoscopy, other etiologies should be evaluated before ascribing this adverse event to the pneumoperitoneum.
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