Recent Developments in the Perioperative Management of CKD
Recent Developments in the Perioperative Management of CKD
The complications of chronic kidney disease (CKD) present the anaesthetist with a number of clinical challenges related in part to altered drug handling and to difficulties with vascular access and fluid balance. Safe anaesthetic management requires an understanding of CKD pathophysiology to prevent aggravation of pre-existing disease. This review will consider some recent changes in the management of adult patients with CKD as they affect the anaesthetist. It will consider medical problems associated with CKD together with new developments in perioperative management.
Chronic kidney disease (CKD) is defined as either a glomerular filtration rate (GFR) of <60 ml min 1.73 m for 3 months or more, irrespective of cause, or kidney damage leading to a decrease in GFR, present for 3 months or more. The damage may manifest as abnormalities in the composition of blood or urine, on radiological imaging, or in histology. It is classified into five stages depending on GFR ( Table 1 ).
The complications of chronic kidney disease (CKD) present the anaesthetist with a number of clinical challenges related in part to altered drug handling and to difficulties with vascular access and fluid balance. Safe anaesthetic management requires an understanding of CKD pathophysiology to prevent aggravation of pre-existing disease. This review will consider some recent changes in the management of adult patients with CKD as they affect the anaesthetist. It will consider medical problems associated with CKD together with new developments in perioperative management.
Chronic kidney disease (CKD) is defined as either a glomerular filtration rate (GFR) of <60 ml min 1.73 m for 3 months or more, irrespective of cause, or kidney damage leading to a decrease in GFR, present for 3 months or more. The damage may manifest as abnormalities in the composition of blood or urine, on radiological imaging, or in histology. It is classified into five stages depending on GFR ( Table 1 ).
