01 - CRF and other stuff

Question 1

upper urinary tract: kidneys & ureters

lower urinary tract: bladder and urethra

Question 2

(renal failure)

1. what 2 values are above normal range in renal failure?
2. what is this called?

Answer 2

1. BUN and serum creatinine
2. azotemia

Question 3

(prerenal azotemia)

1. what causes this?
2. 3 causes of this?
3. USG?
4. urine sediment? kidney size?

Answer 3

1. reduced perfusion (nitrogenous waste accumulates)
2. dehydration, shock, CHF
3. highly conc
4. both normal

Question 4

(Postrenal azotemia)

1. 2 causes?
2. USG?
3. sediment?
4. imaging necessary for dx

Answer 4

1. urine leakage into cavities or blockage of outflow from kidneys
2. variable
3. may have RBC or WBC

Question 5

(primary renal azotemia)

1. due to what?
2. USG?
3. sediment?

Answer 5

1. renal parenchymal lesions
2. urine can’t be highly conc

(< 1.04 in dogs and < 1.03 in cats)

3. possible casts, WBCs, proteinuria

Question 6

(azotemia)

1. magnitude of azotemia doesn’t distinguish type
2. what is more important factor to evaluate?

Answer 6

2. USG

Question 7

(azotemia)

(USG)

1. what in prerenal?
2. in primary?
3. in post?

Answer 7

1. high conc
2. not high conc
3. variable

Question 8

(chronic renal failure)

1. CRF occurs with at least what % of functional nephron mass?
2. see increased serum phosphorus at what % loss?

Answer 8

1. 75%
2. 85%

Question 9

(chronic renal failure)

1. cause is usually due to what?
2. higher risk in young or old?

Answer 9

1. idiopathic (probably due to glomerular injury)
2. old

Question 10

(CRF in young animals)

1. usually due to what?

Answer 10

1. familial, infection, toxins

(familial rare in cats)

Question 11

(Causes of CRF)

Answer 11

Question 12

Question 13

(chronic renal failure)

(diagnosis)

1. azotemia, small kidneys, non-regen anemia

anorexia, vomiting, depression, wt loss

(renal bx not specific -> not indicated)

Question 14

Progressive chronic kidney dz eventually results in CRF

1. can detect CKD before CRF: look for what 4 things?

Answer 14

1. kidneys getting smaller, ^renal mineralization, urine conc declines, proteinuria ^

Question 15

Progressive chronic kidney dz eventually results in CRF

progressive self-propagating destructino of the chronically damaged kidney involves what two conditions in the glomerulus?

Answer 15

hypertension and hyperfiltration

Question 16

(CKD)

(tx)

1. feed a renal diet - two major factors of benefit?
2. protein restriction only doesn’t protect kidney from progression - will reduce what though?
3. dietary phosphate restriction may be adquate treatment to control serum phosphorus

Answer 16

1. phosphorus restriction and omega-3 supplementation
2. BUN

Question 17

(CKD)

(phosphorus control)

1. use what to control?

Answer 17

1. intestinal phosphate binders

(aluminimum salts (hydroxide, carbonate) -> mainstay treatment)

Question 18

(CRF)

1. often give stomach stuff (H2 blockers, PPI)
2. why?

Answer 18

2. ^ gastrin (dec renal degradation of gastrin)

Question 19

(CKD)

(ACE inhibition)

1. proven beneficial in treatment of protein-losing nephropathy
2. how is it renoprotective?

Answer 19

2. lowers glomerular hypertension caused by lowering tone of the efferent glomerular arteriolar arteriole

Question 20

(CKD)

(calcitriol therapy)

1. proven benefit for survival in dogs
2. why?

Answer 20

2. decreases PTH (excess PTH is toxic to kidneys)

Question 21

(CKD)

(control of systemic hypertension)

1. important to prevent organ damage (eyes, brain, kidney)
2. uncontrolled hypertension damages nephrons
3. best drug for dogs?
4. for cats?

Answer 21

3. ACE inhibitor
4. amlodopine

Question 22

(progression of CKD and CRF)

1. slower in cats or dogs?

Answer 22

1. cats (months to years)

dogs about a year