ABSTRACT
Anesthesia for patients with renal dysfunction has become commonplace since the advent of renal transplantation 40 years ago, but such patients may also require anesthesia for unrelated conditions and, therefore, present on any operating room list. Particularly if they have had renal dysfunction for several years, their medical history may be complex, and many systems may be affected. It is therefore important to take a full preoperative history and make an examination and to evaluate the drug therapy, which is often complex, that the patient is receiving. This chapter discusses the chronic dialysis techniques available to renal patients and the medical complications which these patients may suffer. The chapter will outline the preoperative preparation required and suggest the most appropriate anesthetic techniques to employ. It will deal mainly with the patient in end-stage renal failure undergoing supportive dialysis treatment, although the same basic principles are applicable to the patient with deteriorating renal function who has not yet reached this stage.
