Volume and hypotension avoidance |
Dialysis timing before and after surgery Volume management on dialysis Antihypertensive medication reconciliation in perioperative period Avoidance of aggressive intravenous fluid administration; adaptation to residual kidney function and urine output
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Electrolyte derangements |
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Anemia |
Complex iron-repletion strategies at baseline Patient likely taking erythropoietin-stimulating agents, with unique adverse effects Lower hemoglobin targets than in the general population For kidney transplantation candidates, blood transfusions present risk of immune sensitization (greater caution should be taken before blood transfusions)
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Bleeding |
Increased risk of perioperative bleeding Different pathophysiology of bleeding, necessitating directed management of bleed risk Altered metabolism of anticoagulants
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Miscellaneous |
Altered metabolism of opioid medications Lack of validated risk-stratification tools Higher risk of postoperative cardiac complications with atypical symptoms, with events more challenging to diagnose
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