I am 76 year old male with stage 3b kidney disease (Creatinine 1.7, GFR 39). I am scheduled for total knee replacement in two weeks. Are there pain medications or types of anesthesia I should NOT take. I have also found an article that a major risk factor for developing AKI increases the risk by 16 % if the GFR is less than 60. Should I rethink whether I should have this knee replacement surgery?

This question is best asked of your primary care physician (PCP) and your nephrologist in consultation.  It is true that the risk is increased but only someone who knows your medical status and can give you an honest appraisal of the risk should be consulted.  In general, we advise against any use of non-steroidal anti-inflammatory drugs (NSAID’s) and also advise against the use of succinylcholine in the anesthetic for patients who have impaired kidney function. I suggest you review your status with your PCP and your nephrologist.

 

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