Continue drug therapy on day of surgery. Chronic poorly controlled hypertension may be associated with hypertrophic cardiomyopathy, especially in older children and teens. Try to elicit symptoms of orthopnea and PND, especially the evening preceding hemodialysis. Severe azotemia is unusual with adequate dialysis therapy. Know the most recent Na, K, Ca, and Mg and correct if possible preoperatively.
Anemia is unusual with adequate erythropoietin therapy, but still occurs occasionally.
Volume status must be known. Children may be hypovolemic if recently dialyzed or hypervolemic if in need of dialysis. The child's weight is the best indicator of volume status. Invasive monitors are usually required. Intra-arterial monitoring is reserved for small children undergoing anastamosis of the allograft to the great vessels.