35. Chronic kidney diseases in dogs and cats. Nephrosis syndrome Flashcards

1
Q

When is kidney disease considered chronic

A

after 3months

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2
Q

Predisposed to CKD

A

Cat > dogs

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3
Q

Pathophys of CKD

A

Chronic decrease in number of functioning nephrons —> decreased GFR

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4
Q

How does CKD usually start in DOG

A

glomerulopathy

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5
Q

How does CKD usually start in CAT

A

tubulointerstitial nephritis

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6
Q

what are glomulopathies

A

Hypercoagulability
Hyperlipidaemia
Proteinuria

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7
Q

How does the loss of functional nephrons lead to CKD

A

The remaining nephrons undergo hyperfiltration —-> glomerulosclerosis —> decreased GFR —> proliferation of fibroblasts and inflammatory cells

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8
Q

Clinical signs of CKD

A

PU/PD
Thrombosis
Inappetence
Poor Coat
Weight loss
Anaemia
Dehydration
CNS Signs
Respiratory signs
GI signs
Immunosuppression
Inactivity
Hypertension consequences

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9
Q

Stage 1 of CKD

A

No azotaemia
Normal Creatinine

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10
Q

Stage 2 of CKD

A

Mild azotaemia
Normal/ mildly elevated creatinine

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11
Q

Stage 3 of CKD

A

Moderate azotaemia

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12
Q

Stage 4 of CKD

A

Severe Azotaemia

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13
Q

Basis of management of CKD

A

Eliminate cause
Treat symptoms
Prolong quality of life
Lifelong management
Application of drugs
Palatibility of diets

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14
Q

How to prolong survival in case of CKD

A

renal diet
decrease phosphorus
Improve appetite
Maintain BCSs
Decrease proteinuria
EPO treatment
Correct BP (amlodipine)

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15
Q

Renal Diet

A

Decreased; protein but increase quality, phosphorus
Increase omega 3, K, Vit B

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16
Q

If the control of water in the body is not functioning then the result is

A

PU/PD

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17
Q

If the control of electrolytes is not functioning then the result is

A

Hypo/er kalaemia, Na, Cl

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18
Q

If the control of pH is not functioning then the result is

A

metabolic acidosis

19
Q

If the control of Ca, P, Mg is not functioning then the result is

A

Hyper phosphataemia, Ca, Mg

20
Q

If the excretion of endogenous waste is not functioning then the result is

A

azotaemia
uraemia

21
Q

If the erythropoeitin production is not functioning then the result is

A

anaemia

22
Q

If the elimination of drugs is not functioning then the result is

A

decreased drug metabolism

23
Q

If the blood pressure control is not functioning then the result is

A

hypertension

24
Q

Glomerular diseases

A

glomerulopathy is aka proteinuria
the glomerular wall retains negative proteins (albumin)
Smaller proteins (+ve) pass through the glomerular wall

25
Q

Causes of glomerulopathies

A

immune complex GN
in situ immune complex formation
non immune complex NG
Amyloidosis
Hydronephrosis

26
Q

Immune complex gn

A

glomerular deposition of immune complexes due to extrarenal disease
- leishmania
- anaplasma
- ehlichia
- lymes
- neoplasia
- inflammation

27
Q

In situ immune complex formation

A

usually against glomerular basement membrane

28
Q

Non immune complex GN

A

congenital
hypotension; gcc; toxins
glomerulosclerosis

29
Q

Amyloidosis

A

Extracellular deposition of amyloid in the kidneys and other organs.

30
Q

Clinical signs of Amyloidosis

A

signs of lower uti
fever
painful kidneys
depression
anaemia
CKD signs

31
Q

Types of Amyloidosis

A

Aquired - underlying inflammatory/ neoplastic disease
Congenital - sharpei, abyssinian cats

32
Q

Diagnosis of Amyloidosis

A

Lab D - leukocytosis, bacteria in urine
Imaging - dialted pelvis
Bacteria in renal pelvis
Bacteria in inflammatory lesions in renal biopsy

33
Q

Treatment of Amyloidosis

A

Long term AB
Eliminate predisposing factors
Nephrectomy

34
Q

Hydronephrosis

A

dilation of renal pelvis due to outflow obstruction

35
Q

Clinical signs of Hydronephrosis

A

Pain
renal enlargement
Signs of CRF

36
Q

Diagnosis of Hydronephrosis

A

US
Excretory urography

37
Q

Treatment of Hydronephrosis

A

Surgery
Relieve obstruction
Nephrectomy

38
Q

cause of Nephrotic syndrome

A

Severe glomerulopathy –> severe proteinuria —> severe hypoalbuminaemia –> nephrosis syndrome

39
Q

4 criteria of Nephrotic syndrome

A

Proteinuria
Hypoalbuminaemia
Hyperlipidaemia
Extracellular fluid accumulation

40
Q

Lab D of Nephrotic syndrome

A

Persistent, severe proteinura
Normal urine sediment
Normal kidney parameters
Hypoalbuminaemia
Hypercholesteraemia
UPC ration

41
Q

Diagnosis of Nephrotic syndrome

A

Renal biopsy
Urine electrophoresis

42
Q

Treatment of Nephrotic syndrome

A

Decrease proteinuria
immunosuppression
amyloid prevention

43
Q

Standard treatment of proteinuria

A

Renal diet
Omega 3
Inhibition of RAS (enalapril, telmisartan)
Antihypertensive treatment (amlodipin)
Antiplatelet treatment
anticoagulant treatment (aspirin)