నైరూప్య

Multimodal anesthesia for kidney retransplantation in patients with advanced renal osteodystrophy.

Lucia Caroline Schons1, Carlos Darcy Alves Bersot2, Rafael Linhares3, Jose Eduardo Guimaraes Pereira4,5*

End-stage renal failure is a chronic, progressive, debilitating disease that causes disability and high mortality, and the incidence and prevalence have increased in the world population. Among the chronic diseases, dialysis chronic kidney disease is among those that generate the greatest impact on the patient's quality of life, such as living with an incurable disease, dependence on a dialysis machine to survive, rigorous therapeutic regimen, changes in body image and dietary and water restrictions. Dialysis therapy does not completely replaces renal functions and, for this reason, prolonged stay on hemodialysis causes bone complications (ostedystrophy due to secondary hyperparathyroidism), cardiovascular (left ventricular hypertrophy, vascular calcification), brain (advanced arteriosclerosis). The chance of death among hemodialysis patients is 20 times greater than that of the general population. Kidney transplantation is the best treatment for patients with end-stage renal disease. Anesthesia requires an understanding of these metabolic and systemic abnormalities. In addition, associated comorbidities increase perioperative morbidity and mortality, so for a better outcome, multidisciplinary collaboration with well-planned anesthetic strategies is necessary, with individualization of cases.