Fluid management in kidney disease patients for nontransplant and transplantation surgeries

Abstract

Kidneys play an essential role in the regulation of water homeostasis, electrolyte balance, and acid–base balance. Anesthesiologists are frequently involved in the perioperative care of patients with kidney disease in elective and emergency scenarios. Fluid therapy is a main component of resuscitation to improve cardiac output, blood pressure, and perfusion pressure. This sometimes comes at a cost of increased risk of tissue edema due to fluid overload. Both during the transplant and nontransplant surgeries, the use or choice of fluid may influence the biochemical environment or homeostasis of human body and clinical outcomes. In this narrative review, we address the electrolyte and acid–base changes in renal disease, pharmacology of fluids, hemodynamic monitoring, and their applications.

Keywords

• fluid management
• kidney diseases
• nontransplantation
• perioperative
• transplantation surgeries