Acute Kidney Disease Flashcards
How is acute kidney disease classified?
Sudden onset of haemodynamic, filtration and excretory failure of the kidneys
A rise in what metabolite gives a good indication of kidney disease?
Creatinine
What is significant about the clinical signs of acute renal disease?
They are often non-specific .. HISTORY IMPORTANT
Rupture of the bladder or urethral obstruction are examples of what kind of renal failure?
Post-renal
What should you note about the kidneys on physical examination?
Size
What’s the 3 basic causes of azotaemia?
High production of waste, Low GFR, Reabsorption of urine escaped from urinary tract.
What are the 3 basic causes of low GFR?
Reduced renal perfusion, intrinsic or functional renal disease, urinary obstruction
A dog presents with symptoms that could be a result of kidney disease.. What is the first diagnostic test you should perform ?
urinalysis
What are the USG parameters for indication of pre renal azotaemia?
> 1.030 dog
>1.035cat
What are the USG parameters for indication of renal azotaemia?
<1.035 cat
How severe azotaemia will you see in an animal with unilateral ureter blockage?
None as the other functional kidney should compensate
How will response to fluid differ between pre-renal and renal azotaemia?
Pre-renal azotaemia will show a dramatic response whereas primary renal will show very little
What is pyelonephritis?
inflammation of the renal pelvis
How should you treat pyelonephritis?
Culture urine and then treat aggressively with antibiotic therapy
What would you expect to see on first glance of a CKD patient in comparison to AKD patient ?
poor body condition and coat
What bacterial infection causes interstitial nephritis?
Leptospirosis
What other disease processes are associated with leptospirosis?
Hepatic necrosis, icterus, vasculitis, thrombocytopaenia
What notable size differences would you see in the kidneys of chronic and acute disease?
In chronic disease the kidneys are small and fibrosed, in acute the kidneys are swollen
What antimicrobials are associated with kidney disease?
aminoglycosides, tetracyclines and amphotericin B
What other groups of drugs except anti -biotics can cause kidney damage ?
Chemotherapy drugs, NSAIDS, ACE-inhibitors and IV contrast agents
What is the best strategy for managing AKD?
Prevention. Many cases occur as a result of hospitalisation
List 5 things that make a patient at risk of AKD?
Pre-existing CKD, Dehydration, Hypovolaemia, Hypotension, sepsis, fever, hyperthermia, systemic disease, prolonged anaesthesia and drug therapy
What is the principle of treating AKD?
removal of inciting cause and keep animal alive so kidney can repair
How can a tubule repair?
Viable cells stretch over gaps and then proliferate to rebuild functional tubule
What effect does the drug diltiazem have?
improves renal blood flow
What should your therapy aim to do in treating AKD in terms of clinical signs?
Correct fluid deficits, treat acidosis, rectify potassium balance
What effect does frusemide have on kidney function?
It increases urine output and increases calcium excretion
What effect does dopamine have on the kidney?
Suggested to increase renal blood flow and renal dilation in low doses
