RT Journal
A1 Kellerman PS
T1 PErioperative care of the renal patient
JF Archives of Internal Medicine
JO Archives of Internal Medicine
YR 1994
FD August 8
VO 154
IS 15
SP 1674
OP 1688
DO 10.1001/archinte.1994.00420150030004
UL http://dx.doi.org/10.1001/archinte.1994.00420150030004
AB Due to the hormonal and hemodynamic alterations inherent in the surgical experience, acute renal failure is common during the perioperative period. Acute renal failure occurs in 5% of hospital admissions, and the surgical setting is the second most common cause of inpatient acute renal failure. Because this setting has the highest mortality for acute renal failure, recognition of high-risk patients is essential for careful monitoring and prophylactic measures. Patients with chronic renal insufficiency, elderly patients, jaundiced patients, diabetics, and those undergoing cardiac or aortic surgery are at greatest risk for perioperative acute renal failure. Patients with severe chronic renal failure or end-stage renal disease are at significant risk for development of complications during the perioperative period, due both to renal and nonrenal reasons. Hyperkalemia, infections, arrhythmias, and bleeding commonly occur in these patients during the perioperative period. This population has a reasonable surgical mortality for both general and cardiac surgery, but the extremely high morbidity warrants careful perioperative monitoring and care.(Arch Intern Med. 1994;154:1674-1688)