[Anesthesia for nephrectomy in a functional hemirenal patient].

Area of Science:

• Nephrology
• Surgical Anesthesiology
• Renal Physiology

Background:

• A 79-year-old female patient with right renal cell carcinoma underwent surgical resection.
• The patient was functionally hemirenal due to left kidney atrophy, increasing perioperative risks.

Observation:

• Fluid management was critical to prevent overhydration in a patient with compromised renal function.
• The FloTrac system was utilized to monitor hemodynamic parameters closely.

Findings:

• Central venous pressure (CVP) was maintained between 4-6 cmH2O.
• Stroke volume variation (SVV) was kept within the 20-30% range during the procedure.

Implications:

• Precise hemodynamic monitoring and fluid management can prevent acute kidney injury in high-risk surgical patients.
• Avoiding overhydration is crucial for patients with solitary or atrophic kidneys undergoing major surgery.
• This approach successfully averted the need for urgent postoperative hemodialysis, improving patient outcomes.