Renal Disease

Renal disease is a common pathology faced when providing anesthesia to today's pet population. Renal disease is broadly classified as acute kidney injury (AKI) or chronic kidney disease (CKD). AKI can occur over a period of hours to days and is due to several processes, including toxicities, infection, and inflammatory conditions. AKI describes a wide range of severity and prognoses. Patients with AKI can present with coexisting abnormalities in acid–base status, electrolytes, and the biochemical profile that may affect patient anesthetic management. Patients with AKI or CKD should have an electrolyte panel analyzed prior to anesthesia, ideally just prior to sedation or the anesthetic event. Although multiple electrolyte abnormalities can accompany both AKI and CKD, hyperkalemia is the most lifethreatening and may require immediate correction. Hypertension can be present in patients with CKD and will cause shifts in individual organ autoregulatory ranges.