Study Questions 3.3 Renal Disease

Front 1

What are the 2 general considerations for kidneys?

Back 1

How anaesthesia may affect renal function
>Indirect damage: changes in perfusion and oxygenation
>Direct damage

How renal function may alter activity of anaesthetic agents
>Reduced excretion and increased duration
>Prolonged duration

Front 2

What are 3 essential pre- operative assesments?

Back 2

1.Hydration status
Clinical exam
PCV/TS

2.Electrolytes

3.Renal function
USG
BUN/creatinine

Front 3

What are the two indication for IVF?

Back 3

PU/PD= Higher than normal requirements for crystalloids


Chronic renal disease causes anaemia
Transfusion indicated
Dogs PCV < 20%
Cats PCV < 15 %

Front 4

What are the preffered agents for premed?

Back 4

Morphine and Methadone
>Minimal CV depression = good renal perfusion
> No renal excretion

Front 5

What pre meds should you use with care and why?

Back 5

Ace :Good anxiolytic but bad renal perfusion

Ketamine: VC reduces renal perfusion
renal excretion of metabolites.

Avoid: Xylazine, detomidine, romifidine, diuresis and decreased CO

Front 6

What are the preffered induction method and agents?

Back 6

IV
Alphaxlone, fentanyl and diazepam

>no effect on renal perfusion and
> reduce dose of induction agent

Front 7

What should you avoid

Back 7

Ketamine and thiopentone

>CV depressant
>uraemia increases active drug
> not renal excretion

ketamine
>reduced renal perfusion
> metabolites excreted renally

Front 8

maintenace

Back 8

Inhalation: iso, sevo
>Good
Titrateable
No renal excretion
Modern agents not nephrotoxic

>bad
Dose dependant CV depression
> can reduce with intraoperative opiods
>nerve blocks re

Front 9

5 supportive care

Back 9

1. high O2
2.IVFT
3. Adequate PVC
4. ventilation
5. opiods

Front 10

What are the preffered peri operative analgesia?
What should be avoided and why?

Back 10

Methadone + Morphine
>Minimal CV effects
> MInimal renal excretion

Rimadyl and metacam
>interferes with renal blood flow.