Perioperative Anaesthetic Management of Urological Patients with Chronic Kidney Disease

Background: Chronic kidney disease is a prevalent global health problem associated with increased perioperative risk. Patients with CKD frequently require urological surgery and pose significant anesthetic challenges due to altered drug metabolism, fluid imbalance, and multiple comorbidities. Careful perioperative anesthetic management is essential to reduce complications, preserve renal function, and improve surgical outcomes in this high-risk population. Objectives: To evaluate perioperative anesthetic management, patient characteristics, and surgical outcomes among urological patients with chronic kidney disease. Methods: This hospital-based observational study was conducted at North East Medical College Hospital, Sylhet, from June 2022 to September 2023. A total of 256 CKD patients aged 40 years and above undergoing urological surgery were included. Data on demographics, CKD stage, comorbidities, anesthetic techniques, and perioperative outcomes were collected and analyzed using SPSS version 23 with descriptive statistical methods. Results: Among 256 patients, most were aged ≥60 years (42.6%) with a mean age of 58.4±12.6 years, and males predominated (63.3%). Stage 3 CKD was most common (42.2%), with 79.7% having moderate to severe disease. Hypertension (64.1%) and diabetes (38.3%) were frequent comorbidities. TURP was the commonest surgery (32.0%). General anesthesia was used in 63.3%. Hypotension occurred in 16.4%, while 56.3% had uneventful recovery. Conclusion: Urological patients with chronic kidney disease require careful perioperative anesthetic management to minimize complications and improve surgical outcomes.