Internal Medicine: Urinary: Introduction and Clinical Approach Flashcards
What hormones do the kidney produce?
- Renin
- Erythropoietin
- Calcitrol
What is chronic kidney disease?
Stuctural abnormalities of one or both kidneys that have been there for over 3 months
What is acute kidney injury?
Sudden inability to maintain fluid, acid-base and electrolyte balance
Why does kidney disease cause PUPD?
- Increased filtered load per surviving nephron
- Disruption of normal countercurrent system
- Impaired response to ADH
Why does kidney disease cause anorexia?
Oral pain
Nausea
Gastritis
Acidosis
Hypokalaemia
How can haematuria be used to show where disease is present?
Throughout- upper UT
End- lower UT
Between- urethral/prostatic/genital
What can be mistaken as polyuria?
- Urinary incontinence- dribbling
- Cystitis- pollakiuria, stranguria
- Submissive urination
- Marking behaviour
What is affected for kidnet disease on haematology and biochemistry?
Haematology
* Haematocrit
* Haemoglobin
* RBC
* Total WBC
* Neutrophils- banded and segmented
Biochem
* Urea
* Creatinine
Why is creatinine more reliable for GFR?
Not reabsorbed in the PCT
What causes a decrease in albumin?
Protein losing nephropathy
What is the sterile and non sterile method of urinalysis?
Sterile- cystocentesis
Free catch/catheteristion- not sterile
How can urine be grossly examined?
Colour
* pale yelow to amber- normal
* red to brown- haematuria
* dark yellow/brown- billirubinuria
Turbidity- normal is clear
How can protein on a dipstick be interpreted?
Trace is normal
* interpret alongside SG
Interpret along side sediment
* no sediment- renal proteinuria
* Active- bladder or genital tract issue
Dog
What are the following specific gravity ranges?
1. 1.001-1.007
2. 1.008-1.012
3. 1.013-1.029
4. >1.030
- Hyposthenuria < plasma
- Isothenuria = plasma
- Intermediate range- slightly concentrated
- Hyperthenuric
Hypo- diabetes insipidus, psychogenic PD, cushing’s
