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Related Concept Videos

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Preoperative ManagementThe primary goals of preoperative management in kidney transplantation are to optimize the patient’s metabolic state and prepare them for surgery through diet adjustments, necessary dialysis, and tailored medical treatment. This phase also involves comprehensive infection screening and patient education about the surgical procedure and postoperative care to improve outcomes and adherence.Medical ManagementA comprehensive evaluation is required for both the living...
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Related Experiment Video

Updated: Mar 24, 2026

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Patient with chronic renal failure undergoing surgery.

Melanie Meersch1, Christoph Schmidt, Alexander Zarbock

  • 1Department of Anesthesiology, Intensive Care and Pain Medicine, University of Muenster, Muenster, Germany.

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Summary

Managing patients with chronic kidney disease (CKD) undergoing surgery requires careful risk assessment and optimization of renal function. Preventing acute kidney injury (AKI) is paramount to avoid complications and disease progression in CKD patients.

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Area of Science:

  • Nephrology
  • Perioperative Medicine
  • Surgical Management

Background:

  • Chronic kidney disease (CKD) presents significant global health challenges, particularly in surgical patients.
  • Effective perioperative management strategies are essential to prevent complications and CKD progression.

Purpose of the Study:

  • To review recent studies on strategies for managing patients with CKD undergoing surgery.
  • To highlight the importance of nephroprotection in the perioperative setting for CKD patients.

Main Methods:

  • Review of recent studies focusing on perioperative management of CKD patients.
  • Analysis of strategies for risk assessment, hemodynamic stability, glycemic control, and AKI prevention.

Main Results:

  • Identification of CKD patients via risk assessment and biomarkers (e.g., cystatin C) is crucial.
  • Maintaining hemodynamic stability, adequate blood pressure, and fluid balance reduces AKI incidence.
  • Tight glycemic control is linked to less renal impairment and improved survival in CKD patients.
  • Prevention of acute kidney injury (AKI) is a top priority with proven efficacy.

Conclusions:

  • Preoperative identification and risk stratification are critical for managing CKD patients undergoing surgery.
  • Optimizing renal function, avoiding nephrotoxic drugs, and preventing AKI improve clinical outcomes.
  • Postponing nonemergent procedures allows for better patient preparation and renal optimization.