Approach to and Management of Acute Azotaemia in Small Animals Flashcards

1
Q

What is the most common hospital test for renal disease

A

Urinalysis

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2
Q

What does Glomerular Filtration Rate measure

A

Excretory function of kidneys

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3
Q

Where is Urea synthesised

A

Liver

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4
Q

Where is urea excreted

A

freely filtered by glomerulus, undergoes tubular resorption depending on renal flow rates

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5
Q

In biochemistry what is the name of the marker used to measure Urea

A

BUN – blood urea nitrogen

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6
Q

Where is creatinine synthesised

A

muscle, breakdown of phosphocreatine

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7
Q

Where is creatinine excreted

A

freely filtered by glomerulus, no tubular resorption

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8
Q

Serum levels impacted by

A

Altered muscle mass
Altered renal blood flow
Altered renal function
Altered renal outflow

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9
Q

Limitation of creatinine test

A

Increases do not develop until GFR has decreased to 25%
Doesn’t tell you why the creatinine is increased
Need to consider a patients baseline
Will not distinguish between acute or chronic kidney disease

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10
Q

Synthesis of SDMA

A

Metabolism of animo acids during protein breakdown (arginine residues)

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11
Q

Excretion of SDMA

A

Freely filtered, not resorbed

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12
Q

Benefit of SDMA test

A

Not influenced by muscle mass
Increases with earlier changes in GFR (more sensitive test)

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13
Q

Limitation of SDMA test

A

Will not tell the difference between acute or chronic kidney disease
Only available through IDEXX laboratories

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14
Q

Definition of Azotaemia

A

Increase in the concentration of non-protein nitrogenous wastes in blood (urea and creatinine)

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15
Q

Definition of uremia

A

Clinical syndrome of renal disease,high levels of urea in blood

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16
Q

Clinical signs - uraemia

A

Inappetance
Depression
Vomiting/ Nausea
Halitosis
Oral ulceration/stomatitis
Diarrhoea

17
Q

Common causes of azotaemia (pre renal)

A

Hypovolaemia
Hypotension
Aortic/renal thromboembolism

18
Q

Common causes of azotaemia (renal)

A

Nephron damage
Nephron loss

19
Q

Common causes of azotaemia (post renal)

A

Ureterolith
Urethrolith
Bladder rupture

20
Q

What is Acute Kidney Injury (AKI)?

A

Sudden, often reversible reduction of the elimination and metabolic functions of the kidneys. AKI is a medical emergency

21
Q

Causes of acute kidney injury

A

Reduced perfusion- Dehydration,Hypotension, shock
Nephrotoxic drugs- NSAIDS/Doxorubicin(Chemo)/Aminoglycosides(AntiB)
Toxicities- Lilies(cats)/Grapes(Dogs)/Anti freeze
Infections- Leptospirosis/ Borreliosis (lyme disease)
Ureteral obstructions-Ureteroliths

22
Q

How to differentiate between acute and chronic kidney disease

A

History/Body condition/Presence of anemia

23
Q

Normal urine output formula

A

1-2ml/kg/hr

24
Q

Oliguria formula

A

<0.25ml/kg/hr

25
Q

Polyuria formula

A

> 2ml/kg/hr

26
Q

AKI treatment

A

Remove inciting cause
Restore renal perfusion
Monitor urine output and consider drugs to increase urine output (if needed)
Monitor weight, electrolytes, acid base balance regularly (Prevent fluid overload)
Treat uraemic complication and provide nutrition