This course takes a deep dive into how the kidneys maintain homeostasis—filtration, electrolyte control, RAAS, and acid–base balance—and what that means for your anesthetic plan. You’ll compare volatile agents like sevoflurane and desflurane, review their historical and current nephrotoxic concerns, and explore how modern anesthetics (including IV agents) can both harm and protect renal function. Practical perioperative strategies for patients with AKI, CKD, or ESRD are emphasized, helping you choose drugs, manage fluids, and tailor your approach to preserve kidney function and improve outcomes.