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Preserving renal function in surgical patients.

C Whiteside-Yim, F T Fitzgerald

    The Western Journal of Medicine
    |March 1, 1987
    PubMed
    Summary
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    Preventing postoperative acute renal failure involves understanding modifiable risk factors. Physicians can minimize complications in at-risk patients, even those with chronic renal failure, through careful management.

    Area of Science:

    • Nephrology
    • Surgical Medicine
    • Critical Care Medicine

    Background:

    • Postoperative acute renal failure (ARF), particularly with oliguria, is linked to high mortality and morbidity.
    • Physician awareness of preventable risk factors is crucial for mitigating this complication.

    Purpose of the Study:

    • To highlight key risk factors and management strategies for preventing postoperative acute renal failure.
    • To emphasize that chronic renal failure is not an absolute contraindication for surgery.

    Main Methods:

    • Review of risk factors associated with postoperative acute renal failure.
    • Discussion of management strategies for patients with pre-existing renal conditions undergoing surgery.

    Main Results:

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    • Patients with underlying renal disease, sepsis, volume depletion, renal hypoperfusion, or severe liver disease are at increased risk.
    • Minimizing exposure to nephrotoxic agents and managing intravascular volume are key preventative measures.

    Conclusions:

    • Effective management of patients with chronic advanced renal failure requires multidisciplinary collaboration (internists, anesthesiologists, surgeons).
    • Understanding metabolic and organ system disorders is essential for preserving renal function.
    • Elective or emergent surgical procedures can be safely performed in patients with chronic renal failure.