Renal Renal

Impaired renal function prolongs the plasma half-life of drugs eliminated via the kidney and may alter fluid, electrolyte and acid-base balance, so screening for renal function is important before anaesthesia.

It is good practice to administer a balanced solution intravenously before and during anaesthesia to facilitate control of fluid, electrolyte and acid-base balance and to maintain renal perfusion. If renal hypotension occurs during anaesthesia tubular ischaemia may result leading to acute tubular necrosis and renal failure. Advancing age and general anaesthesia are both important risk factors for the development of acute renal failure. Other risk factors include the administration of non-steroidal anti-inflamdrugs (NSAIDs), aminoglycosides, tetracyclines and other nephrotoxic drugs (Polzin 1991).