Renal Disease Flashcards
Dan Hladky, CAA
Renal Impairment

Evaluating Renal Function

Creatinine Clearance

Staging of kidney disease using GFR

Serum Creatinine

Creatinine Clearance Formula

Blood Urea Nitrogen (BUN)
Function decreases, BUN rises
Rises with more protein
Normal 10-20 mg/dL (Not reliable marker for GFR)
Higher than 50, usually renal impairment

Acute Renal Failure (ARF)
Acute Kidney Injury (AKI)

Chronic Renal Failure (CRF)

Complications of Chronic Renal Failure (CRF)

Hyperkalemia
Ampule (1g) of calcium will immediately lower the peak of the T wave

Hypocalcemia


Chronic Renal Failure (CRF) Symptoms
https://www.youtube.com/watch?v=sEnp2ss8VoA (Flapping Tremor)

CRF Stages

Uremic Frost

Manifestation of Renal Failure

Hemodialysis (3)


Peritoneal Dialysis


Dialysis Complications

Dialysis Disequilibrium Syndrome

Cardiovascular Effects of Dialysis


Anesthetic Agents with Renal Failure

Management
Acute renal failure

Preop & Induction Agents

Volatile Agents Effects with Renal Failure

Opioids & Anticholinergic Agents with Renal Failure

Muscle Relaxants for Renal Failure

Reversal Agents with Renal Failure

Sugammadex
Controversial with renal failure

Preoperative Evaluation

Premedication and Induction

Maintenance and Fluid Therapy
Volume Depletion and Detection


Stroke Volume Variation


Pulsus Paradoxus


Volume Depletion and Detection

Stroke Volume Variation or
Reverse Pulsus Paradoxus

Systolic Pressure Variation (SPV)

Preventing Renal Problems

Anesthesia for Patients with Mild to Moderate Renal Impairment

Anesthesia for Patients with Mild to Moderate Renal Impairment

Renal Dose Dopamine
Renal surgery (Cystoscopy)
Renal surgery (Cystectomy, nephrectomy, and prostatectomy)

Large bore IVs

TURP Syndrome (Water intoxication)

CNS Symptoms of TURP

Cardio-respiratory and systemic symptoms of TURP

Diagnosis of TURP

Prevention of TURP


Management of TURP

TURP Syndrome (Correction of hyponatremia)

