Anaesthesia management in Chronic Kidney Disease (CKD) patient undergo repair pseudoaneurysms surgery: a case report
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Keywords
Chronic kidney disease, Hemodialysis, Pseudoaneurysms, General anesthesia
Abstract
Introduction: Chronic kidney disease (CKD) is marked by the presence of kidney damage (usually defined as estimated GFR < 60 mL/ min/1.73 m2) for 3 or more months, and it may be caused by a multitude of disease processes. Management of patients with CKD includes aggressive treatment of the underlying cause, pharmacologic therapy to delay disease progression and prevent complications, and preparation for hemodialysis as ESRD ensues.
Case presentation: In this case report, a 48-year-old man with a pseudoaneurysms due to the insertion of a vascular access for hemodialysis, undergo repair pseudoaneurysms surgery under general anesthesia, at the Sanglah General Hospital, October 2020. The patient came with fully awareness, blood pressure 145/95 mmHg, heart rate 85 times per minute regular and oxygen saturation 97% with room air.
Conclusion: General anesthesia in patients with CKD requires an understanding of the pathologic changes that accompany renal disease, co-existing medical conditions, and the impact of reduced renal function on drug pharmacokinetics.
References
2. Hastie, J. Renal Physiology, in Shafer S. (ed.), Stoelting’s: Pharmacology & Physiology in Anesthetic Practice 5th Edition. Philadelphia: Wolter Kluwer Health; 2015. pp. 418-31.
3. Butterworth, JF, Mackey, DC & Wasnick, JD. Anesthesia for Patients with Kidney Disease’, Morgan & Mikhail’s Clinical Anesthesiology 6th Edition. Philadelphia: Wolter Kluwer Health; 2018. pp. 631-69
4. Kasper DL, Braunwald E, Fauci, AS, et al. Nephrology. Harrison’s Manual of Medicine 20th Edition. New York: McGraw-Hill Education; 2020. pp. 711-810
5. Dhar P, Yao FS. Kidney transplant. in: Yao FS(ed), Yao & Artusio’s Anesthesiology: Problem Oriented Patient Management 6th Edition. Philadelphia: Lippincott Williams & Wilkins; 2008. pp. 824–47.
6. Lok CE, Huber TS, Lee T, et al; KDOQI Vascular Access Guideline Work Group. KDOQI clinical practice guideline for vascular access: 2019 update. Am J Kidney Dis. 2020;75(4) (suppl 2): S1-S164.
7. Forsyth JM, Shalan A, & Thompson. Venous Access Glossary, Venous Access Made Easy. Boca Raton: Taylor & Francis Group; 2019. pp. 3-8
8. Suhardi. Vascular Trauma Management, paper presented at Nasional Symposium & Workshop “Aceh Surgery Update 2”, Banda Aceh 16 – 17 September 2017
9. Hata, MH. Preoperative Patient Assesment and Management, in Barash PG (ed.), Clinical Anesthesia 7th Edition. Philadelphia: Lippincott Williams & Wilkins; 2013. pp. 583-611.
10. Putri YS, Yadi DF. Axillary Block on a Patient with Pseudoaneurism on Left Antebrachii with Terminal Renal Failure. Jurnal Anestesi Perioperatif. Bandung; 2014;2(1):79-84.
11. Bodenham, AR. Complications of central venous access, in Hamilton H (ed.), Central Venous Catheters. West Sussex: Wiley-Blackwell; 2009. pp. 175-205.
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Tan Andi, Resident of Department of Anesthesia and Critical Care Medicine, Faculty of Medicine, Universitas Udayana, Sanglah General Hospital, Bali, Indonesia
Resident of Department of Anesthesia and Critical Care Medicine, Faculty of Medicine, Universitas Udayana, Sanglah General Hospital, Bali, Indonesia
Tjahya Aryasa, Instructor of Department of Anesthesia and Critical Care Medicine, Faculty of Medicine, Universitas Udayana, Sanglah General Hospital, Bali, Indonesia
Instructor of Department of Anesthesia and Critical Care Medicine, Faculty of Medicine, Universitas Udayana, Sanglah General Hospital, Bali, Indonesia
Tjokorda Gde Agung Senapathi, Associate Professor, Department of Anesthesia and Critical Care Medicine, Faculty of Medicine, Universitas Udayana, Sanglah General Hospital, Bali, Indonesia
Associate Professor, Department of Anesthesia and Critical Care Medicine, Faculty of Medicine, Universitas Udayana, Sanglah General Hospital, Bali, Indonesia