A 22-year-old woman presented for Caesarean section at 34 weeks' gesta
tion. She had chronic renal failure, with a glomerular filtration rate
of 14 mt min(-1) and was treated with twice weekly dialysis. We descr
ibe the potential problems of the case including cardiovascular instab
ility, fluid balance and some of the effects of uraemia. We also descr
ibe the anaesthetic management of the case.