chronic renal failure Flashcards
what is chronic kidney disease
progressive
irreversible loss of kidney function
end stage is chronic renal failure
How do kidneys recover from AKI
adaptive repair
why can kidneys not recover from CKD
maladaptive repair occurs
what are the 2 broad categories of causes of CKD
primary glomerular disease
primary tubulointerstitial disease- AKI/ARF causes (most common cause in olderhorses)
what are the clinical signs of CKD
weight loss
PUPD
ventral oedema
poor appetite
dull hair coat
dental tartar
why does ventral oedema occur in CKD
due to hypoalbuminaemia from protein loss in the disease kidney - this means the protein levels are higher in the tissues so fluid moves out to compensate this
why are small increases in creatinine important in AKI
this can represent a big change in GFR to come just out of normal
why are small increases in creatinine not as important in CKD
because the small change in creatinine represents a small change in GFR when you are further away from normal values
what can transabdominal ultrasound be used for in renal disease
to look for nephroliths and check the size of the kidney
why is the right kidney biopsied instead of the left in horses
the spleen gets in the way of the left kidney
are renal biopsies useful for CKD
yes
Management of CKD
treat primary cause
avoid nephrotoxic drugs
provide plenty of fresh water - encourage diuersis
does CKD need IVFT
no
what changes do we want to make to the diet in CKD patients
balanced protein, low salt, low carbohydrates
how often should we check creatinine levels in CKD horses
every 3 months
