Patients with chronic kidney disease

Chronic kidney disease (CKD) is a major public health problem worldwide. Roughly 1 in 10 adult Americans has CKD. These patients are at significant risk for excessive morbidity and mortality during the perioperative period. Given the health and cost burden of end-stage renal disease (ESRD), preventing or avoiding progression of CKD to ESRD is critical. Therefore, identifying risk factors and implementing risk mitigation strategies to prevent further deterioration of renal function during the perioperative period is of paramount importance. This article reviews patient risk stratification, preoperative evaluation and management, and perioperative interventions for renal protection.