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Small Animal Internal Medicine > Assessing Renal Function > Flashcards

Assessing Renal Function Flashcards

1
Q

What are 4 causes of increased blood urea nitrogen?

A
  1. Post-prandial
  2. Dehydration
  3. GI bleeding
  4. Catabolic drugs
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2
Q

What are 3 causes of decreased blood urea nitrogen?

A
  1. Malnutrition
  2. Severe burns
  3. Hepatic dysfunction
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3
Q

Creatinine increases with __1__ and __2__.

A
  1. Muscle mass

2. High protein diet

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4
Q

In which 2 breeds are creatinine levels naturally high?

A
  1. Birmans

2. Greyhounds

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5
Q

Which is more accurate, BUN or creatinine?

A

Creatinine

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6
Q

What does SDMA stand for?

A

Symmetric dimethylarginine

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7
Q

When can SDMA detect renal dysfunction?

A

At 40% loss of function

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8
Q

Which of the following is influenced by muscle mass: creatinine, BUN, or SDMA?

A

Creatinine

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9
Q

When does renal azotemic develop?

A

With 75% loss of function

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10
Q

What are the 4 substances used for clearance assays to measure GFR?

A
  1. Inulin
  2. Iohexol
  3. Creatinine
  4. Radioisotopes
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11
Q

What is the easiest and most commonly used substance for clearance assays?

A

Iohexol

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12
Q

What are 4 indications for using a clearance assay?

A
  1. Identifying occult renal failure prior to starting nephrotoxic drugs
  2. Assessing renal function in non-azotemic PU/PD patients
  3. Screening patients with familial history of kidney disease
  4. Investigating discrepancies in BUN and creatinine
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13
Q

What is one benefit to renal scintigraphy?

A

Ability to measure each individual kidney’s GFR

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14
Q

What are the disadvantages of renal scintigraphy?

A
  1. Expensive
  2. Special facilities
  3. Limited availability
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15
Q

What are the sources of proteinuria?

A
  1. Physiological - fever, seizures, intense physical activity
  2. Non-urinary - genital tract inflammation (vaginitis, prostatitis), hyperglobulinemia (multiple myeloma), hemoglobinemia (hemolytic anemia)
  3. Urinary - glomerular disease, uroliths, UTIs, bladder tumors
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16
Q

The glomerulus allows passage of molecules less than ___-___ kDa

A

67-70 kDa

17
Q

Resorption of most molecules (glucose, amino acids, HCO3, electrolytes) occurs where within the nephron?

A

Proximal tubule

18
Q

What are 2 causes of renal proteinuria?

A
  1. Increased loss of glomeruli

2. Decreased reabsorption in tubules

19
Q

A dip stick can be used to quantify protein loss but primarily detects what?

A

Albumin

20
Q

Which has more protein loss: (+) protein with USG 1.040 or (+) protein with USG 1.008?

A

(+) protein with USG 1.008

21
Q

What is a normal urine protein/creatinine ratio in the dog?

A

< 0.5

22
Q

What is a normal urine protein/creatinine ratio in the cat?

A

< 0.4

23
Q

What are the 3 main roles of the renal tubules?

A
  1. Water conservation
  2. Acid/base balance
  3. Reabsorption of metabolites
24
Q

What is the renal tubular reabsorption threshold for glucose in the cat?

A

290 mg/dL

25
Q

What is the renal tubular reabsorption threshold for glucose in the dog?

A

180-220 mg/dL

26
Q

On average, the kidneys filter about ____ litters of water/day.

A

100 L

27
Q

Of that 100 litters, less than ___% is lost to the urine.

A

1%

28
Q

What is the specific gravity a ratio of?

A

Ratio of the weight of urine vs. weight of an equal amount of water

29
Q

What is the isosthenuric range of urine?

A

1.008 - 1.012

30
Q

At what concentration is urine equal to the osmolality of plasma?

A

1.008 - 1.012

31
Q

What do you call urine with a USG of < 1.008?

A

Hyposthenuric

32
Q

What are 4 drugs that cause the urine to be dilute?

A
  1. Steroids
  2. Diuretics
  3. Colloids
  4. Anti-epileptics
33
Q

What are 4 concurrent diseases that might affect the USG?

A
  1. Dehydration
  2. Endocrine diseases (DM, cushing’s, addison’s)
  3. Electrolyte abnormalities (hypercalcemia)
  4. Infections (pyometra, pyelonephritis, leptospirosis)
34
Q

What 3 things does one need to concentrate their urine?

A
  1. ADH
  2. ADH receptors
  3. Functional kidneys
35
Q

After running a water deprivation test and getting dilute urine, what is your next step?

A

Administer DDAVP (synthetic ADH)

36
Q

If you get a response with synthetic ADH, what is your diagnosis?

A

Central DI

37
Q

If you do not get a response with synthetic ADH, what is your diagnosis?

A

Nephrogenic DI

38
Q

Because the water deprivation test is no longer recommended by most internists anymore, what is an alternative to test water conservation of the renal tubules?

A

Vasopressin test

Small Animal Internal Medicine (36 decks)

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