Complications during surgery in chronic kidney disease patients

Renal dysfunction represents a wide spectrum of conditions with various consequences on peri-operative management due to not only the underlying disease processes but also from the intervening medical and surgical therapies. Such patients need optimization prior to surgery. In this regard, this review is focused upon the surgical difficulties faced and peri-operative evaluation of patients who have renal dysfunction. Approximately 1% of patients undergoing surgery are estimated to at risk for AKI with an increased risk in certain patient population. Hospitalization rates in CKD is three times higher while that for acute kidney injury is six time higher than the patients with normal renal function. Complete evaluation is required in patients with renal disease who requires surgery. Currently no guidelines exist for the safe pre-operative potassium and hematocrit levels. To decrease peri-operative mortality and morbidity hemodialysis should be done a day before surgery.