Acute renal failure

Most perioperative ARF is ischemic in origin. The kidney is in a unique position to monitor the status of the cardiovascular system. The effects of anesthesia and operation on the kidney are due primarily to changes in hemodynamic function. When cardiovascular performance is inadequate, powerful forces tend to reduce renal blood flow. These effects are mediated by the sympathetic nervous system, the renin-angiotensin system, prostaglandins, vasopressin, and aldosterone. Therefore, careful monitoring of kidney and cardiovascular function coupled with appropriate therapy will prevent most perioperative renal failure.