Acute Kidney Disease

Question 1

How is acute kidney disease classified?

Answer 1

Sudden onset of haemodynamic, filtration and excretory failure of the kidneys

Question 2

A rise in what metabolite gives a good indication of kidney disease?

Answer 2

Creatinine

Question 3

What is significant about the clinical signs of acute renal disease?

Answer 3

They are often non-specific .. HISTORY IMPORTANT

Question 4

Rupture of the bladder or urethral obstruction are examples of what kind of renal failure?

Answer 4

Post-renal

Question 5

What should you note about the kidneys on physical examination?

Answer 5

Size

Question 6

What’s the 3 basic causes of azotaemia?

Answer 6

High production of waste, Low GFR, Reabsorption of urine escaped from urinary tract.

Question 7

What are the 3 basic causes of low GFR?

Answer 7

Reduced renal perfusion, intrinsic or functional renal disease, urinary obstruction

Question 8

A dog presents with symptoms that could be a result of kidney disease.. What is the first diagnostic test you should perform ?

Answer 8

urinalysis

Question 9

What are the USG parameters for indication of pre renal azotaemia?

Answer 9

> 1.030 dog

>1.035cat

Question 10

What are the USG parameters for indication of renal azotaemia?

Answer 10

<1.035 cat

Question 11

How severe azotaemia will you see in an animal with unilateral ureter blockage?

Answer 11

None as the other functional kidney should compensate

Question 12

How will response to fluid differ between pre-renal and renal azotaemia?

Answer 12

Pre-renal azotaemia will show a dramatic response whereas primary renal will show very little

Question 13

What is pyelonephritis?

Answer 13

inflammation of the renal pelvis

Question 14

How should you treat pyelonephritis?

Answer 14

Culture urine and then treat aggressively with antibiotic therapy

Question 15

What would you expect to see on first glance of a CKD patient in comparison to AKD patient ?

Answer 15

poor body condition and coat

Question 16

What bacterial infection causes interstitial nephritis?

Answer 16

Leptospirosis

Question 17

What other disease processes are associated with leptospirosis?

Answer 17

Hepatic necrosis, icterus, vasculitis, thrombocytopaenia

Question 18

What notable size differences would you see in the kidneys of chronic and acute disease?

Answer 18

In chronic disease the kidneys are small and fibrosed, in acute the kidneys are swollen

Question 19

What antimicrobials are associated with kidney disease?

Answer 19

aminoglycosides, tetracyclines and amphotericin B

Question 20

What other groups of drugs except anti -biotics can cause kidney damage ?

Answer 20

Chemotherapy drugs, NSAIDS, ACE-inhibitors and IV contrast agents

Question 21

What is the best strategy for managing AKD?

Answer 21

Prevention. Many cases occur as a result of hospitalisation

Question 22

List 5 things that make a patient at risk of AKD?

Answer 22

Pre-existing CKD, Dehydration, Hypovolaemia, Hypotension, sepsis, fever, hyperthermia, systemic disease, prolonged anaesthesia and drug therapy

Question 23

What is the principle of treating AKD?

Answer 23

removal of inciting cause and keep animal alive so kidney can repair

Question 24

How can a tubule repair?

Answer 24

Viable cells stretch over gaps and then proliferate to rebuild functional tubule

Question 25

What effect does the drug diltiazem have?

Answer 25

improves renal blood flow

Question 26

What should your therapy aim to do in treating AKD in terms of clinical signs?

Answer 26

Correct fluid deficits, treat acidosis, rectify potassium balance

Question 27

What effect does frusemide have on kidney function?

Answer 27

It increases urine output and increases calcium excretion

Question 28

What effect does dopamine have on the kidney?

Answer 28

Suggested to increase renal blood flow and renal dilation in low doses