Patients with chronic kidney disease: safety aspects in the preoperative management

Chronic kidney disease (CKD) is a major public health problem worldwide. Early detection and treatment of CKD can often prevent or delay some of the negative outcomes of CKD. This chapter shows how treatment of hypertension, proteinuria and metabolic disorders slow down the deterioration of renal function. Irrespective of the mode of renal replacement therapy, maintaining the veins in the upper extremities is of vital importance. Below are suggestions on how to protect blood vessels of the upper limbs and when to start preparing for the construction of vascular access. In this chapter, it is also shown how necessary it is to conduct a clinical evaluation of the blood vessels, which is required before the start of vascular access management. The methodology of noninvasive evaluation of vessels by duplex sonography is also presented. This method is very useful, especially if the vessels are not clinically visible, as well as the information concerning the morphological and functional properties of blood vessels.