Lecture 4 Flashcards
Causes of prerenal azotemia
Dehydration GI fluid loss Acute blood loss Hypotension Endotoxemia
What will you see with pre-renal azotemia
Anything that causes inadequate renal perfusion
Usg greater than 1.025 if azotemic
FC(na) less than 1%
Greater than 50% reduction in azotemia after 24 hours of fluid therapy
Causes of intrinsic renal azotemia
AKI- abrupt decrease in GFR
Acute tubular necrosis- most common cause
Describe ischemia
“Vasomotor nephropathy”
Prolonged hypotension
Blood loss
What does aminoglycoside toxicity cause
Proximal tubular epithelial cell damage
Aminoglycosides= neomycin, kanamycin, gentamicin, amikacin, streptomycin
Describe pigment nephropathy
Pigments cause vasoconstriction and therefore ischemia
Obstruct tubules with protein casts
Make hydroxyl radicals
How are animals exposed to lepto
Urine
Aborted fetuses
Clinical syndromes of lepto
AKI
Tubulointerstitial nephritis
Uveitis
Abortion, stillbirths, neonatal death
Clin path of AKI
Increased BUN, cr, K, and P
Decreased Na, Cl, Ca
UA- blood, protein, casts, glucose, increased GGT and FC(na)(P)
Treatment of AKI
Discontinue nephrotoxic drugs Treat concurrent dz Correct volume deficits and establish diuresis Monitor for urination and edema Treat hyperkalemia
AKI prognosis
Varies with underlying cause
Of oliguria persists more than 72 hr, prognosis is guarded
Causes of AKI
Prerenal or post renal azotemia Ischemia Aminoglycosides Oxytetracycline, polymixin B, amphotericin B NSAIDs Pigment nephropathy Leptospira interrogans Acute glomerulonephritis
Describe chronic kidney disease
Acquired- glomerular (glomerulonephritis, amyloidosis); tubular (chronic interstitial nephritis, incomplete recovery from ATN, pyelonephritis, obstructive disease)
Congenital- renal hypoplasia, dysplasia, PKD
Clinical signs of CKD
Uremia Chronic weight loss Rough hair coat Poor athletic performance Anemia PU/PD Ventral edema Ulcers, halitosis, tartar
Describe clin path findings of CKD
BUN:Cr > 10:1
Increased Ca and lipids Decreased P, Na, and Cl Metabolic alkalosis Non regenerative anemia Isosthenuria
Treatment of CKD
Treat acute exacerbation as AKI
Abx if pyelonephritis
Discontinue any nephrotoxic drugs, alfalfa, and legumes
Maintain normal protein intake and BCS
Describe AKI (table)
Good BCS Normal hematocrit Kidney size normal to increased Kidney consistency normal to soft Recent association with disease or drugs BUN:Cr less than 10:1 HypoCa, hyperP Normal or hypoechoic on US
Describe CKD (table)
Poor bcs/ weight loss Anemia Kidney size normal to decreased Kidney consistency normal to firm No recent history of other disease Hyperechoic on US BUN:Cr greater than 10:1 HyperCa, hypoP
