Acute Renal Failure
GENERAL PRINCIPLES
Surgery has been associated with an increased risk of acute renal failure (ARF).109
• Patients with CRI are at increased risk of ARF.
• ARF among patients with normal preoperative renal function is a relatively rare event but is associated with increased mortality when it occurs.111
DIAGNOSIS
• The approach to ARF in the perioperative setting is not substantially different from that in the nonoperative setting (see Chapter 13, Renal Diseases).
• However, certain additional factors have to be considered when evaluating the cause in the perioperative setting:
î Intraoperative hemodynamic changes, particularly hypotension, should be investigated. Intraoperative vasopressor and diuretic administration have been associated with postoperative ARF.
TREATMENT
For a detailed discussion regarding the management of ARF, please refer to Chapter 13, Renal Diseases.