Renal dysfunction and fluid and electrolyte disturbances.

Abstract:

PURPOSE OF REVIEW:To examine recent developments in preventing and treating postoperative acute renal dysfunction. To review contemporary issues concerning perioperative fluid and electrolyte management. RECENT FINDINGS:Renal dysfunction remains a major postoperative morbidity despite the advent of intermittent and continuous renal replacement therapies. It is also associated with increased mortality. Newer techniques, such as off-pump coronary artery bypass surgery, which promised to reduce the incidence of postoperative renal injury, have failed to do so. In addition, newer techniques such as endovascular repair of aortic disorder and the transcutaneous insertion of aortic valves are associated with substantial degrees of kidney injury partially due to the use of much intravenous contrast material. Therefore, the present-day approach to preventing contrast-induced nephropathy is reviewed. Electrolyte disturbances are especially problematic after certain types of surgery, such as trans-sphenoidal adenomectomy and surgeries requiring the use of large volumes of irrigating solutions. SUMMARY:Renal dysfunction, along with fluid and electrolyte disturbances, is a major issue that needs to be considered as part of perioperative management. Moreover, it is the prevention of clinically significant renal injury and electrolyte disturbances that is the cornerstone of contemporary anesthetic and surgical care.

journal_name

Curr Opin Crit Care

authors

Hashem R,Weissman C

doi

10.1097/MCC.0b013e328348bef5

subject

Has Abstract

pub_date

2011-08-01 00:00:00

pages

390-5

issue

4

eissn

1070-5295

issn

1531-7072

journal_volume

17

pub_type

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