Normal renal functions are important for every organ system of the body to function and maintain life. Normal renal functions are required for the excretion of anesthetics and medications, maintaining fluid and acid-base balance, and regulating hemoglobin levels. Perioperative renal failure is associated with a high morbidity and mortality. Preexisting renal insufficiency, advanced age, diabetes, and hypertension increase the risk of perioperative renal failure significantly. Realizing these problems are common in the community you have to make a through preanesthetic assessment to identify risk factors and make a necessary preparation. In this session you will learn to adopt knowledge, skill and attitude in safe management of anesthesia for a patient with renal failure.