Anesthetic Challenges in a Pediatric Patient With Chronic Kidney Disease Complicated by Dilated Cardiomyopathy Undergoing Non-cardiac Surgery

患有慢性肾病并伴有扩张型心肌病的儿科患者接受非心脏手术时面临的麻醉挑战

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Abstract

Dilated cardiomyopathy (DCM), a primary myocardial disorder, manifests through the dilation of one or both ventricles, coupled with systolic and valvular dysfunction. Renal agenesis is a congenital condition characterized by the absence of one or both kidneys at birth. Unilateral renal agenesis, wherein one kidney is absent, can subtly evade detection due to the impressive adaptability of the remaining kidney, often preserving typical functionality. Nevertheless, when compounded with chronic kidney disease (CKD), the repercussions of renal agenesis become notably more pronounced. CKD and DCM represent two significant and interrelated clinical challenges, particularly in pediatrics. This case report examines the anesthesia management of a 10-year-old female with CKD and right renal agenesis complicated by DCM undergoing bilateral hemi-epiphysiodesis for genu valgum correction. It emphasizes the crucial role of a multidisciplinary approach in achieving favorable outcomes in patients undergoing non-cardiac surgery.

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