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Clinical Reproduction & Urology > Clinical Approach of Renal Dz > Flashcards

Clinical Approach of Renal Dz Flashcards

1
Q

What is the functional unit of kidney

A

nephron

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2
Q

What is the function of the nephron?

A
  • regulation of volume & composition of ECF –> production of urine
  • plasma ultra-filtration
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3
Q

What is GFR

A

rate at which blood circulates thru glomerulus & rate urine is produced

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4
Q

Changes in GFR means there is

A

renal dysfxn

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5
Q

decrease in GFR means

A

kidney dz

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6
Q

what is a common marker of GFR changes?

A

Azotaemia

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7
Q

Changes of GFR means there can be what conditions?

A

AKI or cKD

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8
Q

proteinuria is a sign of

A

kidney dz, specific to glomerular damages

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9
Q

proteinuria is independent from

A

a decrease in GFR

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10
Q

PU/PD is a sign of

A

renal dz

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11
Q

Non-specific reported clinical signs of renal dz

A
  • lethargy
  • weight loss
  • anorexia/inappetence
  • V
  • uraemic crisis
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12
Q

Signs referable to systemic hypertension (more in cats than dogs)

A
  • blindness
  • hyphaemia
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13
Q

Potential nephrotoxicity can occur b/c of…

A
  • toxin exposure
  • infectious agents
  • medications
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14
Q

indicators of azotaemia

A
  • urea
  • creatinine
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15
Q

pre-renal leads to

A

decreased perfusion

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16
Q

If USG >1.030 (dogs) or >1.035 (fel) then azotaemia is

A

pre-renal or higher

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17
Q

pre-renal azotaemia is usually caused by

A

dehydration

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18
Q

renal causes of azotaemia

A

CKD or AKI

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19
Q

post-renal causes of azotaemia

A

Lower UT obstruction or rupture

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20
Q

What is the gold standard for testing for renal dz

A

GFR

21
Q

serum creatinine concentration is a surrogate for

A

GFR

22
Q

Every time the GFR decreases by half, then

A

S-creat doubles

23
Q

serum creatinine conc is influenced by

A

muscle mass

24
Q

increases in serum creatinine means there are

A

irreversible losses in kidneys

25
Q

S-creatinine can increase by what % after a meal?

A

20% - measure on fasted P

26
Q

BUN is less … than creatinine

A

specific & sensitive

27
Q

BUN should always be interpretted w/

A

creatinine

28
Q

BUN is great for

A

the level of toxins & consequence of renal fxn

29
Q

Low GFR means

A

there is an impaired ability to excrete proteinaceous catabolites (excreted by GFR)

30
Q

BUN acts as a surrogate for all…

A

uraemic toxins, correlating w/ uraemic clin signs (V, ulcers, lethargy…)

31
Q

What is the goal of a low protein diet>

A

limit uraemic toxin production

32
Q

BUN increases w/

A

GI ulcers/bleeding
Enhanced protein catabolism
Dehydration/pre-renal azotaemia
Drugs

33
Q

BUN decreases w/

A

PSS or other hepatic failure, low protein diet

34
Q

SDMA has a strong correlation w/

A

GFR & S-creatinine

35
Q

Hyperphosphataemia

A
  • decline in GFR = retention of PO4
  • Serum PO4 conc = directly linked to mortality in human, cats, dogs w/ CKD
  • Ca x PO4 product = assoc’d w/ increased mortality
  • Reduced intake of PO4 only way to control & limit PO4 retention
36
Q

Metabolic acidosis

A
  • common finding in CKD
  • promotes V, anorexia, lethargy, muscle wasting, weight loss
  • balance maintained by tubular excretion of H+ via ammonium or PO4 & reabsorption of bicarb
37
Q

Reduced reabsorption of HCO3- not typical in

A

feline & canine CKD

38
Q

Calcium

A
  • ionised Ca can be up or down in P’s w/ CKD
  • Hypocalcaemic in cats w/ CKD
  • Total Ca in cats w/ CKD hypercalcaemia
39
Q

K

A
  • AKI: accumulates in blood –> life-threatening –> arrhythmias, death
  • CKD: lost due to fibrosis/leak in UT, HypoK, supplement
40
Q

Hypokalaemia is common in CKD of what species?

A

cats

41
Q

primary hyperaldosteronism occurs in geriatric cats - it has what conditions?

A

severe hypokalaemia, polymyopathy, refractory hypertension

42
Q

USG is essential to differentiate

A

pre-renal from primary renal dz

43
Q

Adv’d CKD has what USG?

A

Isosthenuria (1.008-1.012), kidneys no longer modifying urine conc from plasma conc

44
Q

USG < 1.006 means

A

not consistent w/ renal azotaemia –> urine dilution req’s proper renal fxn

45
Q

Non-regen anaemia

A

Lack of EPO, slow progression w/ dz progression

46
Q

Infectious dz screening in urinary tract

A

UTI +/- pyelonephritis
14-15% dogs w/ azotaemia
WBC
Lepto
Borreliosis
FIP

47
Q

AKI is potentially

A

reversible

48
Q

Chronic renal dz

A

irreversible & progressive loss of kidney fxn (3+ mos)

49
Q
A

Clinical Reproduction & Urology (29 decks)

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