Kidney Sx Flashcards
T/F: Interlobar branches to the kidney do not cross midline
True
What are some surgical diseases of the kidneys?
Neprholithiasis Pyelonephritis Trauma Neoplasia Hydronephrosis Pseudocysts Renal parasites
What is nephrolithiasis?
Kidney stones
What is the common crystal that leads to nephrolithiasis?
Ca oxalate- no medical management therapy
What are CS associated with nephrolithiasis?
Depression, anorexia, hematuria, pain
What are dx tests ran for nephrolithiasis?
Survey rads and U/S
When is sx indicated with nephrolithiasis?
Obstruction or infection is associated with calculi
What is the sx approach for a nephrolithotomy?
Ventral midline celiotomy
What is the most common technique used for closure of a nephrolithotomy?
Close the nephrotomy by apposing the cut tissues and
applying digital pressure for approximately 5 minutes while restoring blood flow through the renal vessels. Then oppose the capsule with a continuous suture pattern
What is the max time a vascular clamp can be used on the kidneys?
20 minutes-any longer would cause damage to the parenchyma
When is pyelolithotomy performed?
Calculi in renal pelvis and dilated
T/F: There is no risk for thromboemboli with pyelolithotomy?
True- no occlusion of blood supply
What are the dx tests ran for renal trauma?
Contrast excretory, ultragraphy or exploratory
Progressive dilatation of renal pelvis and atrophy of renal parenchyma
Hydronephrosis
What are the CS with unilateral vs. bilateral hydronephrosis?
Unilateral: abdominal distension & palpable mass
Bilateral: severe azotemia & death
T/F: Less than 1 week obstruction of the kidney will result in complete resolution
TRUE
What sx is indicated for a non-functional kidney?
Nephroureterectomy
What is a complication of obstructive uropathy?
Pyelonephritis- ascending infection
What is the name of the giant kidney worm?
Dioctophyma renale
What type of patients do you commonly see giant kidney worm in?
Hunting dogs
What is the most common renal neoplasia?
Renal adenoma
Which dx test can you confirm the kidney being origin of neoplasia?
Rads- cannot confirm
U/S- can confirm
What is the preferred method for renal biopsy?
Exploratory laparotomy
What is the most common neoplasia in dogs?
Renal cell carcinoma
Tx- nephroureterectomy and chemotherapy
What is the most common renal neoplasia in cats?
Renal lymphoma
When is a nephroureterectomy indicated?
severe infection/trauma
Obstructive calculi with persistent hydronephrosis, neoplasia, or transplant
Why is a partial nephrectomy rarely performed?
infrequently performed due to compromised GFR in contralateral kidney
What is the sample size for a renal biopsy?
5-6 glomeruli- cortex!
Collect at least two samples
What are contraindications for renal biopsy?
Coagulopathies, hypertension, chronic hydronephrosis
What are the renal biopsy approaches?
Percutaneous, ultrasound guided, keyhole, laproscopic and wedge/incisional
What is the most common method of renal biopsy?
U/S guided
When is a renal transplant indicated?
irreversible acute renal failure
decompensated chronic renal failure
polysystic dz
WHat does the minimum PCV have to be for a renal transplant-if under minimum what must be done?
30%
Blood transfusion or EPO injection
What is the number one complication of renal transplants?
Acute rejection
What is the closing procedure of a nephrolithotomy if the sutureless technique fails?
If adequate hemostasis is not achieved, or if urine
leakage is a concern, place absorbable sutures through the cortex in a horizontal mattress fashion. Then close the capsule with a continuous suture pattern.
