Anaesthesia in Renal Diseases

Abstract

Patients with chronic renal failure can now be kept alive for many years by intermittent haemodialysis. In the past few years improvements in haemodialysis techniques have resulted in these patients coming to surgery m an almost normal physiological state. But • nevertheless these patients still confront the anaesthetist with numerous problems.

It is the purpose of this study to consider the problems pertaining to anaesthesia presented by such patients and to review the anaesthetic agents and techniques that can be used safely in these patients.

First this thesis described the anatomical and physiological considerations of the kidneys as they are the main organ for maintaining homeostasis of the extracelluar fluid.

The second item was the study of the effects of anesthetic agents and adjuvant drugs on kidney function. They can alter renal function by their effects on the systemic circulation, sympathetic nervous system, endocrine function and in rare instances by direct nephrotoxicity. All these affect renal haemodynamics, autoregulation, renal vascular resistance, intrarenal distribution of blood flow and tubular transport mechanisms.

Thirdly is the study of chronic renal failure, causes, pathophysiology, uraemia and associated biochemical changes