Renal Disease in Older Adults

Renal disease is common in older adults, and it is an important factor to consider in the surgical patient. Of particular concern is the fact that the perioperative period creates significant vulnerabilities to a number of organ systems, and renal disease can often magnify these risks. In addition, de novo injury to the kidneys is a common event in the perioperative period, and it is important that preventive measures are in place to reduce or minimize these events. This chapter reviews the unique management challenges associated with surgery in older adults with renal disease, including the importance of identifying specific sequelae that can present as a result of renal dysfunction and methods to optimize risk during the perioperative period.