Chronic Kidney Disease Flashcards
Roughly how many nephrons must be lost to reduce kidney function?
75%
When CKD is staged at what point level in staging do animals become azotaemic?
2.5
how high at creatinine levels in stage 4?
> 440
What is ptyalism?
salivation
How long of a duration do clinical signs have to occur before you suspect chronic kidney disease?
Over 2 weeks
What is the appearance of end stage kidney disease?
chronic tubulointerstitial nephritis and associated fibrosis
How do you treat CKD?
search for the underlying cause. Control the factors important in disease progression and control factors that increase patient morbidity
What breed of cat is associated with poly cystic kidney disease ?
Persian
Why has it been difficult to stop this genetic defect from spreading?
It often doesn’t develop enough to show clinical signs until middle aged then the cat may have already had some litters
Why is obstructive uropathy often referred to as ‘big kidney, little kidney syndrome’ ?
The obstruction of the first kidney is often asymptomatic and causes it to shrink. Clinical problems only develop when the second kidney obstructs
How can diet help control secondary renal hyperparathyroidism?
by restriction phosphate intake
What else apart from diet can be used to restrict phosphate intake?
Phosphate binders such a aluminium hydroxide
What is proteinuria?
protein in the urine
How can ACE inhibitors be used to treat CKD?
They cause preferential dilation of the efferent arterioles, resulting in a reduction of glomerular capillary pressure and therefore proteinuria
When shouldn’t you use ACE inhibitors?
In animals that are severely azotaemic. (Only use in proteinuric animals)
What levels of protein in the urine are required for an animal to be considered proteinuric?
> 0.4 Cats
> 0.5 Dogs
Why should you worry about potassium levels in cats with CKD?
20-30% are hypokalaemic. Treatment leads to significant improvement in appetite and muscle function
What metabolic change is associated with severely azotaemic animals that have suddenly decompensated from CKD?
Metabolic acidosis
Whats the risk associated with erythropoietin treatment?
Antibodies can develop against the foreign proteins
What is commonly seen in cats with hypertension?
Eye problems, namely retinal detachment, retinal haemorrhage, hyphema
What 2 methods can you use to take blood pressure in cats?
Oscillometric and doppler techniques
When should you treat cats for systemic hypertension?
when blood pressure is more than 170 and occular damage is present
What drug is currently recommended for treatment of hypertension in cats?
amlodipine
