Perioperative management of patients with renal disease.

The patient who has renal disease is susceptible to many potential complications during the perioperative period. The prevention of postoperative acute renal failure (ARF), especially in patients who have existing chronic kidney disease, and management of patients who have end-stage renal disease (ESRD) who are undergoing surgery are challenging. Elimination of risk factors for ARF and early diagnosis of ARF should improve patient outcomes. For patients who have ESRD, a thorough and comprehensive evaluation is necessary to decrease morbidity and mortality associated with the end-organ damage. This article reviews the prevention of postoperative ARF and the perioperative management of patients who have ESRD who are undergoing surgery.