Anesthetic Management for Kidney Transplant in a Young Patient With Mitral Regurgitation: Case Report

Patients with chronic kidney disease who are candidates for transplant may experience changes in capillary permeability, coagulation, and the endocrine system; alterations in the pulmonary vasculature; and cardiac structural and functional changes. Patients with renal replacement by hemodialysis have a mortality rate 30 times higher than those who do not have uremia. According to the onset, duration, and severity of chronic kidney disease, cardiovascular disease will be reflected in baseline function and response to stress. For this reason, it is important to establish the functional condition so that preoperative management can be started and factors inherent to the patient and the surgical procedure can be modified. Here, we report a 29-year-old male patient with chronic kidney disease secondary to renal hypoplasia, with no family history. The patient had renal replacement therapy with peritoneal dialysis and had progressive deterioration of general status, decreased functional capacity, decreased tolerance to physical activity, presence of fatigue and pulmonary congestion, and retention of liquids, with a diagnosis of moderate to severe mitral regurgitation.