Anaesthesia for Chronic Renal Disease and Renal Transplantation

Many patients presenting for urological surgery have chronic renal disease (CRD). They have unique pathophysiology relating to both CRD and its underlying cause and therefore present a challenge to surgeons and anaesthetists. Considerable advances in renal replacement therapy (RRT) and renal transplantation mean that a greater number of these patients are presenting for anaesthesia to assist vascular access procedures and renal transplantation. As their survival increases they also present more frequently for surgery unrelated to their renal disease. The aim of this article is to present the features of CRD that influence the conduct of anaesthesia and to introduce some of the anaesthetic techniques used for this group of patients.