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Effects of anaesthesia on renal function
Direct nephrotoxicity
Indirect - hypotension, ADH release, Aldosterone activation, prostaglandin release changes (autoregulation of renal perfusion)
What drugs have nephrotoxic effects
compound A - sevofluorane
flouride ions
Hypotension
How does renal disease affect anaesthesia
Metabolic acidosis - decreased renal exc, increased active fraction of weak acids, myocardial dysfunction
Hypoprotenaemia - more free drug
Uraemia - more free drug
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