Essentials of Nephrology
The basic functions of the kidney are to maintain fluid and electrolyte homeostasis and metabolism. Renal disease requires the practitioner to be vigilant about fluid homeostasis, acid-base balance, electrolyte management, choice of anesthetics, and potential complications. This requires a thorough understanding of the excretory and fluid homeostatic functions of the kidney, particularly in the neonate and younger child. If not managed assiduously, perioperative renal dysfunction can deteriorate into renal failure or multiorgan system failure resulting in significant morbidity or mortality. The anesthesia provider must understand renal physiology, appropriate preoperative preparation, intraoperative management, and postoperative care of the child with renal disease.
