Describe renal physiology and pathophysiology relevant to anesthesia practice, including renal blood flow, glomerular filtration rate, AKI, and CKD. Recognize the systemic effects of kidney disease and their implications for perioperative care, including cardiovascular, hematological, metabolic, neurological, and gastrointestinal complications. Conduct a comprehensive preoperative assessment of patients with kidney disease, including dialysis history, volume status evaluation, vascular access protection, medication review, and laboratory investigations. Optimize patients before surgery through appropriate dialysis timing, fluid management, and correction of electrolyte abnormalities such as hyperkalemia. Apply principles of anesthetic pharmacology in renal impairment, including selection and dose adjustment of induction agents, volatile anesthetics, muscle relaxants, opioids, and adjunct medications. Develop safe intraoperative anesthetic plans for patients with kidney disease, including selection of anesthetic techniques, hemodynamic monitoring, fluid therapy, and acid-base management. Implement evidence-based renal protection strategies to prevent perioperative kidney injury and avoid nephrotoxic interventions. Provide appropriate postoperative care and pain management, including monitoring for complications, selecting safe analgesics, and planning postoperative dialysis when required.