Anesthesia Q

[Merny5]

I will be needing anesthesia for 2 upcoming surgeries. I have read that anesthesia can harm the kidneys. I was wondering if anyone knows if one type of anesthesia is less harmful than another. When I inquired at the pre op appointment it seemed like they use the standard cocktail for everyone regardless if you have CKD. Thank you

[ShyeLoverDoctor]

HYDRATE! You have to stop eating and drinking at midnight the night before surgery. Please, please drink right up until then. Most patients of course are dehydrated and that makes kidney damager more likely. Do not exceed 64 oz in one day though or you can be very ill and end up in the ED, which happened to me. But be absolutely sure you have drunk the most that is safe that day, and up until late at night.

[Merny5 in reply to ShyeLoverDoctor]

Thank you so much for your response ShyeLoverDoctor. So you drank too much before surgery? May I ask what happened to you?

[ShyeLoverDoctor in reply to Merny5]

I already had severe kidney impairment. It’s a long, long story. But I had GFR 26 going into the operation where they removed my gall bladder, and the next week I was at 24. I asked the surgeon, what happened, I didn’t know my GFR could go down from surgery ? He said Yes it can, especially if you’re dehydrated. Of course I was dehydrated at the time of surgery, my veins were flat and they had trouble putting in an IV. I was very lucky to be born with good veins, phlebotomists have never ever had a problem getting blood. And I have to have the surgery.

The time I gave myself hyponeutremia was about 6 months post transplant. I thought I was dehydrated , because I was retaining water. (I’m sure it was the prednisone). I was having headaches which can mean dehydration. I also had decided that very week that I was going to cut way back on salt in my diet. I drank I think 9 glasses of water one day, 10 the next, thought I was doing the right thing. and then I went to the ER next day I can’t even remember if my doctor saw my labs and told me to go, or what. My sodium had dropped to 124 I think. They gave me saline twice, i was there for a couple of days. The first day they didn’t give me any at all, just observed me! I am not sure, that might have been the time I got C-diff there. I was hospitalized twice in two months. Kidney transplant is not easy.

[Merny5 in reply to ShyeLoverDoctor]

Oh my! Thank you for sharing your experience. You have been through a lot and I’m sorry to hear this. I will take in your suggestions when the time comes. Take care

[Tuffcookie71]

You are smart to be concerned! Yes it can affect your kidneys and so will any heavy duty pain medication they may give you or send you home with. I found this out after I had foot surgery in May! Be sure ckd is in your doctor’s records and you let any and everyone know, that does anything to you…preop testing, anethesologist, nurses, doctors, that you have this disease. Do not assume they will see it in your records!!!

[Merny5 in reply to Tuffcookie71]

Tuffcookie71, thank you for your response. It is really a shame that the patient has to tell all of the medical staff because they may not see it in the records. That is true and frightening. I will be sure to mention this to everyone!

[ShyeLoverDoctor in reply to Merny5]

Tuff cookie is right 100%. You just can’t count on medical staff reading your records.

[Tuffcookie71 in reply to Tuffcookie71]

I told you I had foot surgery in May, I wanted to elaborate a little more about my situation. I went, a week before foot surgery, for pre-op testing. My eGfr was 52. I had surgery on May 15. My primary care physician has a standing bloodwork order for me, every 3 months. When I had my bloodwork done on July 1st, my eGfr was 42! Ever since I learned this, I have drinking water and watching the sodium. I don’t know if this was a direct result of the anesthesia I received, or not, but it is highly suspect. They also sent me home with hydrocodone. I took only a couple of those because I know those are bad for kidneys. Anyway, I am going Tuesday for another bloodwork. If nothing has changed, I am thinking of getting my heart checked out, to see if there is any heart disease going on. My ckd was discovered in 2016 because I had high blood pressure. I take Lisinopril 30 mg for the BP, do not have diabetes, am not over-weight. I am 71 years old.

[Merny5 in reply to Tuffcookie71]

Gosh, I really hope your kidneys recover! My eGFR is in the low 60s. I am 63 and just found out that I have kidney atrophy. I have had high bp for many years and it has been somewhat controlled with medication. My nephrologists said that is most likely the cause. Your reaction to anesthesia concerns me because I need a few surgical joint replacements in the very near future. 😬 I plan to discuss this with my nephrologist before surgery. Thank you so much for your input. Could you please share with me the results of your labs on Tuesday?🙏🏼

[Tuffcookie71 in reply to Merny5]

I will. Stay tuned!

[Tuffcookie71 in reply to Tuffcookie71]

So, since testing on July 1st, with an eGfr of 42, I suggested to my primary care physician that I get bloodwork every month instead of every 3 months. I have been having bloodwork done towards the end of each month. At the end of July my eGfr went up 2 points, to 44. Not much but a step in the right direction. At the end of August my bloodwork showed no change. I was disappointed but determined to keep doing what I was doing. I was drinking nothing but water and lots of it, cooking most meals at home, which meant controlling the sodium, and walking more. In addition, I am taking my BP twice a day. (I take lisinopril 30 ml a day) I had bloodwork done yesterday (Sept 28) and I got the results this morning. My eGfr number had gone up another 2 points, to 46! I am so happy and encouraged to stay with the program! Hoping to get back to the eGfr number of 52, before I had the foot surgery in May.

[PecanSandie]

I just had surgery with anesthesia and a month before that an MRI with contrast. I was so worried about my kidneys being affected but was assured that everything would be okay. I was very worried what my next blood work would look like but I just got back the results and my eGFR was stable so I don't think the anesthesia or contrast dye did any damage. My advice is to make sure you pee just before you are wheeled into surgery, even if you think you don't have to. They will probably start an IV line into your arm and whatever is in it made me want to go even though I thought I wasn't going to have to!

[Merny5 in reply to PecanSandie]

Thank you PecanSandie, I will make sure that I go before they wheel me away.

[Ballspinner]

They used propafol for me when I was on hemodialysis and needed fistulagrams. My problem was that I get nauseous and vomit after anesthesia, so I always asked for Zofran to prevent or lessen that. When I had my transplant I had to repeatedly ask for Zofran until the doctors saw me vomit! You learn to advocate for yourself!

[Merny5]

yes Ballspinner I am beginning to learn that. Sorry that you had to go through that . Thank you for your experienced advice.

[Tuffcookie71]

I had my latest bloodwork done yesterday. My eGfr went from 42 on 7/1 to 44 on 7/29. Not much improvement but I’ll take it! My creatinine was 1.35 on 7/1 and was 1.30 on 7/29. I really think the foot surgery is responsible. I am going to check with my doctor later and see if I can have a basic metabolic panel every month to see if I can get more improvement.

[Merny5]

Well it’s a small improvement. Maybe your kidneys took a hit but they are on the way up back to the 50s. I called my nephrologists office and they assured me that the anesthesia will not affect my kidneys, just drink lots of water is what I was told. I was also told that the aspirin and Mobic won’t hurt me if it is only for a month. I’m not buying that one. I will ask the surgeon if it’s necessary or they can give me something else.

I hope that you can get regular testing and that your GFR goes up and creatinine goes down. 🤞🏼

[Tuffcookie71 in reply to Merny5]

Thanks! I hope things go okay for your surgeries. My doctor has ordered monthly bloodwork for me, to see if I continue to improve.

[Merny5]

Oh that is great news! That was a good idea too

[Tuffcookie71]

I had bloodwork done 11-1-24. The previous month my eGFR was 46. It was 49 on 11-1! My kidneys seem to be recovering from my surgery in May!

[Merny5]

That is terrific news! You are heading in the right direction for sure. Keep up the hard work! My GFR has gone up since my surgery. Go figure🤷🏻‍♀️ but I’ll take it!