Perioperative management of giant symptomatic autosomal dominant polycystic kidney disease: A case report

Yıl 2017, Cilt: 34 Sayı: 4, 291 - 295, 10.10.2019

Cengiz Kaya

Öz

Autosomal dominant polycystic kidney disease
(ADPKD) is an inherited systemic disorder characterized by renal cyst
enlargement which results in abnormal kidney structure and renal insufficiency.
The anaesthesia management of patients with ADPKD is often complex and carries
considerable risks of perioperative complications. Safe and successful anaesthesia
management requires an increased understanding of ADPKD pathophysiology. We report successful
perioperative management of a bilateral open surgical radical nephrectomy on
a male patient with giant symptomatic ADPKD. The patient had chronic renal
failure and extremely large kidneys. We believe that the description and
observations seen in this case will aid in the recognition and anaesthetic
management of this syndrome. 

Anahtar Kelimeler

Polycystic kidney disease, Autosomal dominant, Renal failure, Anaesthetic management

Kaynakça

• Arulkumaran, N., Montero, R.M., Singer, M., 2012. Management of the dialysis patient in general intensive care. Br. J. Anaesth. 108, 183-192.
• Cannesson, M., Desebbe O., Rosamel, P., Delannoy, B., Robin, J., Bastien, O., Lehot, J.J., 2008. Pleth variability index to monitor the respiratory variations in the pulse oximeter plethysmographic waveform amplitude and predict fluid responsiveness in the operating theatre. Br. J. Anaesth. 101, 200-206.
• Capisonda, R., Phan, V., Traubuci, J., Daneman, A., Balfe, J.W., Guay-Woodford, L.M., 2003. Autosomal recessive polycystic kidney disease: Outcomes from a single-center experience. Pediatr. Nephrol. 18, 119-126.
• Chapman, A.B., 2008. Approaches to testing new treatments in autosomal dominant polycystic kidney disease: Insights from the CRISP and HALT-PKD studies. Clin. J. Am. Soc. Nephrol. 3, 1197-1204.
• Cooper, R.A., Mirakhur, R.K., Wierda, J.M., Maddineni, V.R., 1995. Pharmacokinetics of rocuronium bromide in patients with and without renal failure. Eur. J. Anaesthesiol. Suppl. 11, 43-44.
• Corcoran, T., Rhodes, J.E., Clarke, S., Myles, P.S., Ho, K.M., 2012. Perioperative fluid management strategies in major surgery: A stratified meta-analysis. Anesth. Analg. 114, 640-651.
• Dahaba, A.A., von Klobucar, F., Rehak, P.H., List. W.F., 1999. Total intravenous anesthesia with remifentanil, propofol and cisatracurium in end-stage renal failure. Can. J. Anaesth. 46, 696-700.
• Davies, S.J., Minhas, S., Wilson, R.J., Yates, D., Howell, S.J., 2013. Comparison of stroke volume and fluid responsiveness measurements in commonly used technologies for goal-directed therapy. J. Clin. Anesth. 25, 466-474.
• Franz, K.A., Reubi, F.C., 1983. Rate of functional deterioration in polycystic kidney disease. Kidney Int. 23, 526-529.
• Gabow, P.A., 1993. Autosomal dominant polycystic kidney disease. N. Engl. J. Med. 329, 332-342.
• Guay-Woodford, L.M., Desmond, R.A., 2003. Autosomal recessive polycystic kidney disease: The clinical experience in North America. Pediatrics. 111, 1072-1080.
• Gupta, R., Birnbaum, Y., Uretsky, B.F., 2004. The renal patient with coronary artery disease: Current concepts and dilemmas. J. Am. Coll. Cardiol. 44, 1343-1353.
• Halvorson, C.R., Bremmer, M.S., Jacobs, S.C., 2011. Polycystic kidney disease: Inheritance, pathophysiology, prognosis, and treatment. Int. J. Nephrol. Renovasc. Dis. 3, 69-83.
• Hood, J.A., Wilson, R.J., 2011. Pleth variability index to predict fluid responsiveness in colorectal surgery. Anesth. Analg. 113, 1058-1063.
• Kaimori, J.Y., Germino, G.G., 2008. ARPKD and ADPKD: first cousins or more distant relatives? J. Am. Soc. Nephrol. 19, 416-418.
• Litz, R.J., Hubler, M., Lorenz, W., Meier, V.K., Albrecht, D.M., 2002. Renal responses to desflurane and isoflurane in patients with renal insufficiency. Anesthesiology. 97, 1133-1136.
• Locatelli, F., Nissenson, A.R., Barrett, B.J., Walker, R.G., Wheeler, D.C., Eckardt, K.U., Lameire, N.H., Eknoyan, G., 2008. Clinical practice guidelines for anemia in chronic kidney disease: Problems and solutions. A position statement from Kidney Disease: Improving Global Outcomes (KDIGO). Kidney. Int. 74, 1237-1240.
• Maurizio Cereda, P.N., Michael, G.S., Shashaty, Jiri Horak. 2012. Anesthesia and Uncommon Diseases. In: Chronic Kidney Disease. Edited by Fleisher LA, vol. 1, 6th edn. USA: Elsevier Inc., 231-250.
• SarinKapoor, H., Kaur, R., Kaur, H., 2007. Anaesthesia for renal transplant surgery. Acta. Anaesthesiol. Scand. 51, 1354-1367.
• Siswojo, A.S., Wong, D.M., Phan, T.D., Kluger, R., 2014. Pleth variability index predicts fluid responsiveness in mechanically ventilated adults during general anesthesia for noncardiac surgery. J. Cardiothorac. Vasc. Anesth. 28, 1505-1509.
• Suvarna, D., Fernandes. S., 2011. Anesthetic considerations in a patient of autosomal dominant polycystic kidney disease on hemodialysis for emergency cesarean section. J. Anaesthesiol. Clin. Pharmacol. 27, 400.
• Wagener, G., Brentjens, T.E., 2010. Anesthetic concerns in patients presenting with renal failure. Anesthesiol. Clin. 28, 39-54.
• Wilson, P.D., 2004. Polycystic kidney disease. N. Engl. J. Med. 350, 151-164.
• Wuthrich, R.P., Serra, A.L., Kistler, A.D., 2009. Autosomal dominant polycystic kidney disease: New treatment options and how to test their efficacy. Kidney Blood Press. Res. 32, 380-387.
• Zerres, K., Mucher, G., Becker, J., Steinkamm, C., Rudnik-Schoneborn, S., Heikkila, P., Rapola J., Salonen, R., Germino, G.G., Onuchic, L., et al., 1998. Prenatal diagnosis of autosomal recessive polycystic kidney disease (ARPKD): Molecular genetics, clinical experience, and fetal morphology. Am. J. Med. Genet. 76, 137-144.