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Chronic kidney disease (CKD) requires collaborative and comprehensive management. CKD progresses through stages and can lead to end-stage kidney disease (ESKD) if untreated. Interprofessional collaboration and patient education are crucial, enabling patients to manage their health and improve their quality of life.Diagnostic approach for chronic kidney diseaseThe diagnosis of CKD primarily focuses on the glomerular filtration rate (GFR), which assesses kidney function by measuring how well...
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Patients with chronic kidney disease.

Alicia Gruber Kalamas1, Claus U Niemann

  • 1Department of Anesthesia and Perioperative Care, University of California, San Francisco, 521 Parnassus Avenue, PO Box 0648, San Francisco, CA 94143-0648, USA.

The Medical Clinics of North America
|November 5, 2013
PubMed
Summary

Chronic kidney disease (CKD) poses significant perioperative risks. This review highlights strategies for risk stratification, preoperative care, and interventions to protect kidney function and prevent progression to end-stage renal disease (ESRD).

Keywords:
Acute kidney injury (AKI)Chronic kidney disease (CKD)Preoperative assessmentPreoperative evaluationPreoperative management

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Area of Science:

  • Nephrology
  • Anesthesiology
  • Perioperative Medicine

Background:

  • Chronic kidney disease (CKD) affects millions globally, representing a significant public health concern.
  • Patients with CKD face elevated risks of morbidity and mortality during surgical procedures.
  • Progression to end-stage renal disease (ESRD) incurs substantial health and economic burdens.

Purpose of the Study:

  • To identify critical risk factors associated with perioperative kidney function decline.
  • To outline strategies for mitigating renal deterioration in CKD patients undergoing surgery.
  • To emphasize the importance of renal protection during the perioperative period.

Main Methods:

  • Review of patient risk stratification methodologies for perioperative settings.
  • Analysis of preoperative evaluation and management protocols for renal protection.
  • Examination of perioperative interventions aimed at preserving kidney function.

Main Results:

  • Effective risk stratification is crucial for identifying high-risk CKD patients.
  • Comprehensive preoperative assessment and tailored management can optimize patient status.
  • Specific perioperative interventions can reduce the incidence of acute kidney injury and CKD progression.

Conclusions:

  • Preventing CKD progression to ESRD is a critical goal in patient management.
  • A proactive approach involving risk assessment and targeted interventions is essential for perioperative renal protection.
  • Optimizing care for CKD patients during surgery can improve outcomes and reduce long-term healthcare costs.