How are renal risk factors assessed during dermatologic preoperative evaluation and management?

Updated: Mar 16, 2020
  • Author: Robert A Schwartz, MD, MPH; Chief Editor: Dirk M Elston, MD  more...
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Answer

Answer

With the screening procedures of blood urea nitrogen level, creatinine level, and urinalysis, an operation and fluid therapy may proceed with the confidence that the patient can tolerate judiciously managed fluid loads. Patients undergoing massive liposuction procedures requiring fluid replacement of more than 5000 mL should be staged if greater amounts of fat are to be removed.

Patients requiring dialysis are chronically anemic and have acquired platelet dysfunction. However, dialysis patients tolerate most procedures that require general anesthesia well with proper monitoring. The timing of dialysis and appropriate transfusions are important preparations, as is the decision to use heparin. Additionally, catheter drainage of an obstructed urinary tract (as in benign prostatic hypertrophy in elderly men) and elimination of infection should be completed before an elective procedure is performed to allow the return of adequate function.


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