title: From Pre-Existing Renal Failure to Perioperative Renal Protection: The Anesthesiologist's Dilemmas.
abstract: BACKGROUND
  Pre-existing renal dysfunction presents specific features that anesthesiologists must deal with. Anesthesia and renal function are connected and can interfere with each other. Induced hypotension anesthesia and the toxic effects of anesthetic drugs can further deteriorate renal function.
  
  
  METHODS
  Decreased renal function can prolong anesthetic drug effects by decreased elimination of these drugs. Anesthesia can deteriorate renal function and decreased renal function can interfere with drug elimination leading to their prolonged effect. The anesthesiologist must understand all the physiological aspects of the patient, renal protection, and the relationships between anesthetic drugs and renal function. This review article aims to summarize these aspects.
  
  
  RESULTS
  Perioperative renal failure and renal protection is a crucial moment in clinical practice of every anesthesiologist.
  
  
  CONCLUSIONS
  Good knowledges for renal function remain a hallmark of daily practice of the anesthesiologist, considering renal function as an important determinant factor in anesthesia practice.
authors.affiliation: Department of Anesthesiology and Intensive Care Medicine, "Mother Teresa" University Hospital Center, Faculty of Medicine, Medical University of Albania, Tirana, Albania.
authors.forename: Rudin
authors.initials: R
authors.lastname: Domi
authors.affiliation: Department of Anesthesia, American Hospital, Tirana, Albania.
authors.forename: Gentian
authors.initials: G
authors.lastname: Huti
authors.affiliation: Department of Anesthesiology and Intensive Care Medicine, "Mother Teresa" University Hospital Center, Faculty of Medicine, Medical University of Albania, Tirana, Albania.
authors.forename: Hektor
authors.initials: H
authors.lastname: Sula
authors.affiliation: Clinic of Anesthesiology and Intensive Care, University Clinic Center, Faculty of Medicine, "Hasan Prishtina" University, Prishtine, Kosovo.
authors.forename: Nehat
authors.initials: N
authors.lastname: Baftiu
authors.affiliation: Department of Anesthesiology and Intensive Care Medicine, "Mother Teresa" University Hospital Center, Faculty of Medicine, Medical University of Albania, Tirana, Albania.
authors.forename: Myzafer
authors.initials: M
authors.lastname: Kaci
authors.affiliation: Department of Anesthesiology and Intensive Care Medicine, "Mother Teresa" University Hospital Center, Faculty of Medicine, Medical University of Albania, Tirana, Albania.
authors.forename: Artan
authors.initials: A
authors.lastname: Bodeci
authors.affiliation: Clinic of Surgery, Regional Hospital, Fier, Albania.
authors.forename: Albert
authors.initials: A
authors.lastname: Pesha
keywords: Acute Kidney Injury; Anesthesia; Renal Protection