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Acvim Journals 2015-2019 > Nephrology 2015-2019 > Flashcards

Nephrology 2015-2019 Flashcards

1
Q

What is the clinical significance of weight in regards to cats with CKD?

A

Cats have lost an average of 8.9% of body weight prior to diagnosis
patients that weigh < 4.2 kg had a poorer prognosis
Weight loss is accelerated after diagnosis of CKD

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2
Q

What is the overal prevalence of SIRS and sepsis in cats presented to a veterinary teaching hospital?

A

6.2% sepsis
Mortality rate of 33% for septic cats
(javma 2017)

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3
Q

What role does serum magnesium play in cats with chronic kidney disease?

A

Inversely associated with plasma FGF23
Hypomagnesemia in 12% - independently associated w/ death
Magnesium difference not significant in multivariablel analysis
Hypomagnesemia mostly seen in cats w/ IRIS stage 4
(JVIM 2018)

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4
Q

How does magnesium correlated with CKD and nephrolithiasis?

A

Hypermagnesium in 38% and hypomagnesemia in 14.3%
Negaitve correlation with iCa, positive correlationwith phosphorus
Cats with with CKD and nephrolithiasis and magnesium derrangements had higher mortality rate (JFMS 2019)

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5
Q

What biochemical abnormality most strongly correlates with tubulointerstinal damage?

A

serum creatinine

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6
Q

What correlation between urolithiasis and chronic kidney disease has been noted in cats?

A

Prevalence of CKD is higher in cats with uroliths
Negative association of CKD w/ cystoliths
(javma 2017)

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7
Q

What is the overall prevalence of hemorrhagic cystitis in dogs treated with cyclophosphamide and furosemide concurrently?

A

3.6% in a study of 55 dogs

(javma 2016)

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8
Q

What is the correlation between BUN and SDMA in hemodialysis?

A

For every 10% increase in BUN reduction rato, there is a 6.2 ug.dL decreased in SDMA. (JVIM 2019)

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9
Q

What biochemical abnormalities are more likely to occur with patients that are seroreactive for borrelia C6?

A

Thrombocytopenic, azotemic, hyperphosphatemic, anemic, neutrophilic
Hematuria, pyuria more likely, even w/ neg culture
Histopathology often has immune complex glomerlular nephritis

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10
Q

What are the key clinicopathologic and histopathologic renal abnormalities noted in patients with confirmed coccidioidomycosis?

A

63% proteinuric - 25% clinically relevent
13% azotemic
54% of histopathology results had changes suggestive of immune complex glomerular nephritis - 71% had proteinuria

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11
Q

Is cPL linked to survival in hemodialysis-dependent AKI dogs.

A

No
No sig difference between survival or dialysis dependent or nondialysis dependent

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12
Q

What factors are associated with an increased risk for positive urine culture?

A

Low USG, female sex, CKD stage 1 (CKD 4 less, - sample size low, may not be accurate) (JVIM 2019)

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13
Q

Is administration of HES expected to increase AKI in cats?

A

When administered cummulative dose of 98.5 ml/Kg over median of 4 days - no

Effects of Hydroxyethyl starch 130/0.4 on serum creatinine concentration and development of acute kidney injury in nonazotemic cats JVIM 2017

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14
Q

What are considered to be prognositc factors associated with survival in dogs with CKD

A

BCS < 4/9 (1.6)
hyperphos (3.2)
muscle atrophy (2.3)
increased creat (1.4)
increased UPC (3.1 )
increased Calcium Phosphorus Produc (4)
increased FGF-23 (2.6)
Survival times for each IRIS CKD stage were sig different
(JVIM 2018)

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15
Q

What are the known long-term outcomes of cats serving as kidney donors?

A

Median hospitalization 3.5 days
84% had no long term effects
7% developed renal insufficiency or died or developed urinary tract disease (javma 2016)

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16
Q

How does HES impact AKI grade and serum creatinine concentration in dogs?

A

AKI grade not significantly different at evaluated short and long term points
Number of days was associated with increased AKI grade
cummulative dose did not affect

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17
Q

What percentage of CKD patient with a positive urine culture are symptomatic?

A

30% of dogs had positive culture 8% symptomatic
E. coli most common

More dilute urine a risk factor

(JVIM 2019)

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18
Q

What are known risk factors for the development of candida urinary tract infection in dogs?

A

ABX admin w/in 30 days, immunosuppression
DM and hospitalization NOT associated (JVIM 2019)

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19
Q

What is the surivival rate of uroabdomen?

A

79% - more complications = increased mortality
creatining not associated

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20
Q

What is the clinical significance of cystatin C in cats with hyperthyroidism and CKD?

A

Cannot predict CKD and does not change after treatment

Serum cystatin C concentrations in cats with hyperthyroidism and CKD JVIM 2016

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21
Q

What breeds are overrepresented as serorreactive for Borrelia C6?

A

Retrievers and mixes

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22
Q

Which of the following most accurately correlates with GFR: creatinine, SDMA, cystatin C

A

creatinine > SMA > cystatin c

Comparison of the diagnostic value of symmetric dimethylarginine, cystatin C, and creatinine for detection of decreased glomerular filtration rate in dogs JVIM 2019

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23
Q

What urinary marker may increased before UPC in familial amyloidosis in Abyssinian cats?

A

urinary Serum Amyloid A

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24
Q

What correlations can be drawn between periodontal disease and CKD in cats?

A

Periodontal disease had increased risk of associated CKD - highest for IRIS 3 and 4
Increased risk with age
Purebred more likely - Siamese, Himalayan, Abyssinian
General anesthesia w/ 1 yr before study and cystitis at any ponit increased risk
DM or hepatic lipidosis associated with decreased risk (osmotic diuresis in DM and increased BW with hepatic lipidosis)

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25
Q

What comparisons can be made between a ureteral stent and a SUB?

A

Perioperative mortality rate not sig different
Median duration of hospitalization, duration of surgery sig longer for stent vs SUB
Stents also had a higher complication rate, increased likelihood for the need of a second surgery and shorter survival time

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26
Q

How do open vs laprascopic cystotomy compare?

A

Similar surgery time, shorter hospitalization but more expensive for laparascopy. (javma 2016)

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27
Q

Has fenoldopam been show to assist in reduction of AKI in heat stroke patients ?

A

No
No sig difference in survival
AKI in 55%
35% of all dogs died (JVIM 2018)

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28
Q

What is the association between indoxyl sulfate and FGF-23 in cats with CKD?

A

Both significantly decreased with with decrased renal function
Both correlated with phosphorus values; IS more strongly correlated thatn FGF-23
Both significantly increased with progressive disease ( The association of indoxyl sulfate with fibroblast growth factor-23 in cats with chronic kidney disease JVIM 2019)

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29
Q

Is tetrasodium ethylenediamminetetracetic acid solution effective for treatment of SUB mineralization in cats?

A

yes - resolution in 8 subs
Recurrence in 2 cats that resolved with repeat treatment (JVIM 2019)

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30
Q

What are the general risk factors for elevated blood pressure in cats with CKD?

A

Creatinine is an independent risk factor
Increasing age correlates with inceasing BP
Healthy cats at lower risk

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31
Q

What is the clinical significance of biofilm-forming E.coli UTI?

A

53.6% capable of forming a biofilm
decreased liklihood of multidrug resistance
no difference in populations that developed this (JVIM 2018)

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32
Q

What are the expected clinical consequences of hypertriglyceridemia in regards to proteinuria in miniature schanuzers?

A

Those w/ hypertriglyceridemmia and proteinuria had sig decreased albumin, ALP and cholesterol
Significant positive correlation with triglycerides and UPC
No sig difference in BP, BUN, creatinine, AT III, USG, cTnI, glucose or patelet count

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33
Q

What ph and USG are associated with the lowest concentration of bacteria in urine?

A

Alkaline (8.5) and concentrated (1.030)

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34
Q

How does steroid administration impact cystatin C levles?

A

4 mg/kg/day sig increased serum cystatic c
no sig difference in patients w. 2 mg/kg/day poral pred or those with untreated PDH

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35
Q

What are the expected outcomes with nephrolithotomy for the removal of complicated nephroliths in dogs and cats?

A

Median diamter 2.5 cm; most commonly calcium oxalate
15/16 procedures successful
Tearing of renal structures were the most common - all managed successfully

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36
Q

How does benazepril affect surival time of dogs with CKD?

A

It does not
Proteinuria did sig improve as did creatinine

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37
Q

What is the diagnostic utility of in FNA of the kidney in dogs?

A

Sens and spec neoplasia: 78% and 50%
sens snd spec for benign 50% and 77%
sens for lymphoma 100%
Ultrasound w/ confirmed neoplasia varied

Evaluation of the diagnostic utility of cytologic examination of renal fine-needle aspirates from dogs and the use of ultrasonographic features to inform cytologic diagnosis JAVMA 2018

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38
Q

What is the correlation between FGF23 and survival time cats with CKD?

A

survival negatively correlated with plasma creatinine, FGF23, UPC and age
survival positively correlated with PCV
Only independent predictors of ckd progression - log FGF23 and age

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39
Q

What affect does uremia have on body temperature in dogs and cats?

A

Can cause hypothermia that improves with correction of uremia
More prevalent in cats. In dogs BW may play more of a role.

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40
Q

What is the clinical significantce of FGF23 in dogs with CKD?

A

Median higher in CKD vs healthy (582 vs 312 pg/mL)
FGF23 increases with IRIS stage
Positiviely correlated with serum creatinine, phosphorus, PTH

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41
Q

What is the overal prevalence of increased creatinine levels in a veterinary academic medical center?

A

11.5% overall (10.2% inpatient 12.9% out patient)
Relative risk 1.45 for geriatric dogs for having higher

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42
Q

What is the most common bacterial organism cultured in patients with histopathologically confirmed pyelonephritis?

A

E. coli (JVIM 2018)

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43
Q

What are the most common concurrent diseases in patients with histologically confirmed pyelonephritis?

A

Alteraltions in urothelium
neoplaisa NOT in the urinary tract (21%) vs in the urinay tract (6%)
obstructive uropathy
immunosuppresive treatment
alterations in urine composition
urinary incontinence
47% had multiple

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44
Q

What is the overall percentage of hypertensive in apparently healthy senior and geriatric dogs?

A

36% > 180; 53% > 160
overt proteinuria in 13%, borderline proteinuria in 18.5%

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45
Q

What correlation exists between fecal microbiome and CKD in cats?

A

Decreased fecal bacterial diversity and richness

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46
Q

What are general factors that affect postobstructive diuresis following decompressive surgery w/ stent or sub in cats?

A

Serum creatinine, potassium, phosphrus before surgery as well as change correlated w/ duration and maximal severity of diuresis
92% survival - not associated with uni or bilateral
50% of those survived had resolution of azotemia

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47
Q

Can SDMA be used to differentiate between AKI and CKD?

A

No (jvim 2017)

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48
Q

Does SDMA/creatinine ratio correlate with survival?

A

No

(jvim 2017)

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49
Q

What is the diagnostic utility of F2-isoprostanes in cats with CKD?

A

Inversely correlated with serum creatinine and positively correlated with USG
Not significantly increased CKD 1 vs normal

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50
Q

How well does a point of care urinary culture system perform when compared to a reference lab?

A

Sens 93%, 100% spec
77% id’d genus, 58% id’d species
matched susceptibility patterns in 39%

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51
Q

What is the clinical utility of NGAL in cats?

A

When predicting the progression of CKD
Ngal 2.06 ng/mL- sens 77% and spec 75%
UNCR 4.08x10-6 snes 77% and spec 79%
Correlated with creatinine
associated w/ faster deterioration rates

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52
Q

Can the introduction of a asymtomatic strain of bacteria provide clinical benefit in dogs with recurrent UTI?

A

4/9 dogs showed improved improvement by day 14 - 3 had microbiological cures (JVIM 2018)

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53
Q

What is the prevalence of bacteruria in CKD?

A

18.1% positive cultures
Most subclinical 45% -40% pyelonephritis, 15% cystitis
E. coli most common
CKD stage was not associated w/ the presence of bacteriruria or diagnostic category

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54
Q

Does intra-arterial renal infusion of autologous mesenchymal stem cells assist with CKD treatment?

A

So far no (JVIM 2019)

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55
Q

Has morbillivirus or paramyxovirus been shown to correlate with CKD in cats?

A

No

56
Q

What is the sensitivity and specificity for the diagnosis of ureteral obstruction with abdominal ultrasound.

A

Significant, moderate aggreement in ultrasound vs surgery for cause and location
Uroliths - sens - 98% spec 96%
Strictures sens 44% spec 98%

Diagnostic utility of ultrasonography for detection of the cause and location of ureteral obstruction in cats: 71 cases (2010–2016) JAVMA 2019

57
Q

How accurate is the IDEXX SediVue?

A

The SediVue exhibits good agreement with manual microscopy for the detection of most formed elements evaluated, but improvement is needed for epithelial cells.
sens 71%

58
Q

Which is better, SDMA or creatinine as an indicator for renal function during hemodialysis?

A

SDMA (JVIM 2019)

59
Q

What is the clinical significance of using the sututre poliglecaprone 25 as a suture type for PU in cats?

A

18% minor short-term, 1.6% major complicatinos
Pre-op UTI signs are associated w/ level of minor short-term complications

60
Q

How should urine samples destined for urine culture be handled?

A

Immediate samples or refrigerated can be in plain sterile tubes, urine transport tubes are recommended for send out testing or storage at room temperature

(javma 2017)

61
Q

What are the general considerations of survival time in patients undergoing renal transplant surgery?

A

MST 635 days
prolonged anesthesia reduces overall survival rate but not short term
Cats > 12 hears had lower survival rate
All cats that receieved a mu-opiod antagonist survived 30 days
Higher HCT = increased short-term survival
(javma 2015)

62
Q

What are the most common bacterial agents in UTI and is the typicaly susceptibility pattern?

A

E. coli > staph > enterococcus
TMS > clavamox > cephalexin > amox
No oral drug was more than 90% efficacious
multidrug resistance common in complicated UTI

63
Q

What breeds appear to be at higher risk of USMI?

A

Lab, GSD, boxer, beagle GRD, Chihuahua

64
Q

What is the incident rate and risk factors associated with leptospirosis vaccine in dogs?

A

0.26% adverse for any vaccine

0.53% for lepto
reactions more likely if lepto vax given, <6 months old, small dogs <4.5 kg

Hypersensitivity reactions are rare

(Incidence rates and risk factors for owner-reported adverse effects following vaccination of dogs that did or did not receive a Leptospira vaccine javma 2015)

65
Q

What testing method for UPC monitoring is recommended: single, average, pooled?

A

All comparable - dogs w/ UPC > 4 had more variability (JVIM 2018)

66
Q

What affect does AKI have on cPLI, lipase and TLI?

A

None (JVIM 2016)

67
Q

How does iron correlate with CKD in dogs?

A

Mean iron and total iron binding capacity decreased in CKD vs healthy animals
Decreased serum iron concentration in cats with CKD may be associated with chronic gastrointestinal hemorrhage (secondary to uremia‐induced thrombocytopathy), decreased intestinal absorption or intake, or may represent functional iron deficiency caused by hepcidin‐induced sequestration of iron in storage pools

68
Q

What are known serum cytokines that increase in patients with FIC?

A

IL-12, CXCL12, IL018, Flt3L (JVIM 2018)

69
Q

Is endoscopic laser-ablation of orthotopic and ectopic ureteroceles in dogs a viable treatment option?

A

11/13 cases successful
all ureteroceles resolbed w/ improved ureteral/renal pelivic dilation
8/9 inocontience and 3/3 pollakuria resolved

70
Q

What correlations exist between hypotension and lactate in critically ill dogs?

A

In the present study, hypotensive dogs without hyperlactatemia were 3.23 times as likely to survive to hospital discharge than were hypotensive dogs with hyperlactatemia (javma 2015)

Lactate was a more signifant predictor of survival to discharge than hypotension

71
Q

What amino acid changes are noted in dogs with PLN?

A

PLN dogs had sig lower concentrations of leucine, threonine, histidine, glycine, proline, asparagine, tyrosine, o-hydroxyproline, and serine
Dogs may benefit from supplementation

72
Q

Can povidone iodine be used successfully for sclerotherapy as a treatment of idiopathic renal hematuria?

A

2 dogs
retrograde uretropyleopgraphy
5% povidone iodine, 76% meglumine diatrizoate and 5% dextrose X 3
Ureteral stent placed to prevent stricture from possible ureteritis

73
Q

What are the general clinical characteristics, classifications, and surgical outcomes in kittens with phiomosis?

A

igns: stranguria, preputial swelling
Preputial urethrostoymy and circumferential preputioplasty had good reseolution with a mean follow up time of 1.4 years

74
Q

What is diagnostic utility of ultrasound guided pyelocentesis and antegrade pyelography in dogs in cats?

A

Diagnostic rate 94%
Complication rate: 25% overall, mostly minor
Bacterial culture not sig difference with pyelocentesisthan bacterial culture of the bladder

75
Q

What is the possible role of beraprost sodium in the treatment of CKD in cats?

A

Prostacyclin agonist

Serum creatinine increased in placebo but not beraprost over 180 d.

Stabilized phosphorus to calcium ratio

Improved activity scores, appetite
No sig diff in usg, upc
BP not measured

A Double‐blind, Placebo‐controlled, Multicenter, Prospective, Randomized Study of Beraprost Sodium Treatment for Cats with Chronic Kidney Disease JVIM 2018

76
Q

What biomarkers have been shown to most strongly correlate with immuncomplex glomerularnephritis?

A

Frectional excretion of IGM and IgG
Sn/Sp for ICGN: urine IgM:creatinine & urine NAG:creatinine (75%, 78%)

77
Q

What is the sens and spec of an algorithmic machine learning approach in diagnosing CKD?

A

Sens 90%, spec 98.9%

78
Q

Does flushing the urinary bladder have any positive impact on cats treated in hospital for urethral obstrucion?

A

No

79
Q

What is the effect of refrigeration on clinical canine urine samples in regards to positive bacterial culture?

A

Refrigerated samples had decreased CFU but no sig difference in culture results

80
Q

What are known risk factors for urolithiasis in dogs with congenital extrahepatic pss

A

36% has stones
male, older, already received medical treatment (javma 2015)

81
Q

How are SDMA and creatinine correlated with body mass?

A

SDMA not affected but serum creatinine does

82
Q

What are the clacium/creatinine and oxalate/creatinine urine outputs of at risk breeds vs normal contol.

A

Minature schanuzer, bichon, shih tuz
UCa:cr higher compared to controls
Stone diets resulted in higher uca:cr
uox:cr didn’t correlate with stone status

83
Q

What is affect of fenoldopam when administered as a CRI?

A

Significantly increased GFR and increases fracteional excretion of sodium

84
Q

What is a risk factor for ckd in cats?

A

moderate to severe dental disease

85
Q

What are the effects of mannitol administration on the kidneys

A

Increased urine production is short lived after a bolus and similar to that of D5W fluid administartion
Increased fractional excrection of sodium and BUN

86
Q

What are factors associated with a positive urine culture after SUB or ureteral stent placement?

A 
ABX post op = reduced risk 
No risk - CKD, renal implant type, posotop urinary catheterization 
Enterococcus mostcommon (JVIM 2019)
87
Q

What is the clinical significance of vitamin D metabolites in CKD?

A

All metabolites increased in IRIS CKD 3 and 4
Negative correlation between vit D metabolites and PTH, FGF-23 and phosphorus (JVIM 2017)

88
Q

Does vancomycin cause AKI?

A

6/36 patients developed AKI while receiving treatment - could not specifically correlate howeever

Does vancomycin cause

89
Q

What is the clinical utility of neutrophil gelatinase-associated lipocalin (NGAL) in dogs with AKI and recovery?

A

AKI diagnosed earlier based on 7 fold increase in UNCR (uNGAL:creatinine ratio) compared to >50% creatinine
UNCR decrease preceeded creatinine by 2 days
Inreased NGAL seen earlier than UNCR

90
Q

What is the sens and spec for SDMA to predict CKD after treatment with I131?

A

33% sens, 97.7% spec (JVIM 2018)

91
Q

Describe the simplified GFR protocal that has been shown to be accurate using plasma iohexol

A

Plasma iohexol was measured 5, 15, 60, 90, and 180 minutes after injection. Glomerular filtration rate was calculated using 5 samples (GFR5 ) or simplified protocols based on 1, 2, or 3 samples.

92
Q

What is the degree of variablility in first morning USG in healthy dogs?

A

0.015 (JVIM 2019)

93
Q

What is the median time between OVH and documented USMI?

A

3.7 years
Increased weight reduces the interval of spay to USMI

94
Q

Was pyelonephritis more likely to be chronic or acute from a histopathologic perspective?

A

Chronic

95
Q

What percent of cases in a retrospective study of patients with pyelonephritis had ultrasonographic changes?

A

72%

96
Q

What percent of dogs in a retrospecitive study of patients with pyelonephritis had azotemia and a positive urine culture?

A

29% and 79% respectively

97
Q

What is the most significant factor that correlates with dose of amlodipine in cats?

A

Higher bp at start of treatment
plasma levels directly lined to dose administered

98
Q

Is phenoxybenzamine and alprazolam +/- meloxicam an efficacious treatment protocol for obstructive urinary cystitis in cats?

A

No sig different in urinary obstruction rates
may be underpowered

99
Q

In cats, what association between lactate and perfusion variables, blood pressure and outcome exist?

A

Higher lactate in cats w/ white MM, normal pulse quality and hypothermia, hypotension (<90 mmHG), and severe shock
Median lactate did not differ between survivors and nonsurvivors
Changes in lactate were not associated with outcome
(javma 2015)

100
Q

What is the overall prevalnce of sublinical bacteriuria in older cats and does it affect survival?

A

10-13% in nonazotemic zcats - they are predominately female

More common in females (21 times more likely to be female)

no effect on survival

Subclinical bacteriuria in older cats and its association with survival JVIM 2016

101
Q

What is the most common site of rupture and cause for uroabdomen in dogs?

A

urinary bladder (56%) and trauma (47%)

102
Q

What are the key findings in patients undergoing contrast-enhanced ultrasound examination for chronic kidney disease?

A

longer time to peak and shorter mean transit time in the cortex
These findings suggest increased vascular resistance

103
Q

What are important considerations for considering ureteral stents vs ureteral bypass devices when treating urolithiasis in cats?

A

perioperative mortality not sig different
Median duration of hospitalization, duration of surgery both longer for stent vs SUB
Stents had a higher complication rate, increased likelihood of follow up surgery and a shorter survival time (javma 2017)

104
Q

What are the associations between ureteral obstruction and renomegaly, usg and serum creatinine in cats

A

Most consistent finding in ueteral obstruction is increased creatinine
Renomegay was not associated - 62% had renal asymmetery
(javma 2015)

105
Q

What diets may be benefecia in cats with acute nonobstructive FIC?

A

Cats on prevention foods had lower mean incidence rates for recurrent epsiodes, required fewer analgesics

(javma 2015)

106
Q

What is the overall outcome of cats treated with ureterotomy vs ureteral stents?

A

Stented cats had more complications - 14% vs 3%
Similar perioperative mortality rate (9% vs 8%)
lower urinary tract signs were more common in cats with stents
22% repobstruction rate - similar between procedures

(Outcomes of ureteral surgery and ureteral stenting in cats: 117 cases (2006-2014)javma 2016)

107
Q

What is the expected response rate for use of darbopoeitin when used for CKD in dogs

A

85% reaches > 30% HCT
67% Have 10% increase
Median time to >30% is 29 days
Higher doses are more likely to result in 10% change
Positive response did not affect survival time

108
Q

What metabolites have been shown to correlate with hypertension and albuminuria in greyhounds?

A

Eicosanoid metabolites of arachadonic acid
These are consistent with activation of metabolic pathways that promote vascular dysfunction

109
Q

What are some expected outcomes in dogs underoing ureteral stent placement for TX of benign ureteral obstruction?

A

Done mostly for ureterolithiasis
endoscopic vs surgical comparible for successful outcome
Mild creatinine improvement (2 > 1.3 mg/dL mean)
Decreased frequency of UTI - 59% prior vs 26% after
Only 6/44 died from progression of kidney disease
Replacement of stent in 7/556 ureters and 5/43 dogs - median 139 days after original procedure

110
Q

Is treatment of congenital distal ureteral orifice stenosis possible with the use of endoscopic laser ablation?

A

11.5 months median age

15/16 transmura - successful

No complications - all alive in 14.5 months

11/13 improvement in those w/ long term follow up

111
Q

What is the most common serovar of leptospirosis recently id’d?

A

Grippotyphosa

MAT has poor sn for id’ing infecting serogroup (javma 2016)

112
Q

What correlation of weight and calcium oxalate urolithiasis exists?

A

Caox dogs had a greater BCS than control dogs

acidic urine and calcium oxalate crystals were uncommon and NOT adequate predictors of CaOx uroliths

hematuria and proteinuria are common in dogs with CaOx stones

(javma 2017)

113
Q

What is SDMA and how is it linked to kidney function

A

SDMA formed by methylation of arginine and released into blood stream during protein degredation

highly stable in serum and plasma

correlates strongly w/ sereum createinine and decreased GFR

increases when <20% decrease in GFR

114
Q

What are the clinical expectations of telmisartan compared to benazepril in cats with CKD?

A

Telmisartan is noninferior

Decreased proteinuria where benazepril did not

115
Q

Is UPC higher at home vs in hospital?

A

50% are found increased in hospital - 38% had identical and 12% had lower at home

116
Q

What are the effects of feeding a renal diet to a healthy cat?

A

Increased fractional excretion of phorphorus and ical bu no change in plasma phosphage, fgf23 or creatinine

no change in CKD development

117
Q

How much earlier does SDMA increase before creatinine?

A

10 months

118
Q

What is the clinical significance of cystatin C in regards to CKD in cats?

A

Serum CysC could not distinguish healthy from CKD cats, nor normal from borderline or low GFR, in contrast with sCr.

119
Q

is urethral stenting with digital radiography possible and if so, what are the general extected outcomes?

A

Success in all patients (mixture of neoplasia, proliferative urethritis, detrusor-sphincter dyssynergia)

2 procedural complications - may have been alleviated with fluoroscopy

Urinary incontinence in 30%

MST 5 months (2 months for prostatic carcionma and 6 months for tcc)

(Urethral Stenting for Obstructive Uropathy Utilizing Digital Radiography for Guidance: Feasibility and Clinical Outcome in 26 Dogs JVIM 2017)

120
Q

To what degree is NT-pro-BNP and cTnI affected by CKD?

A

No association with measured GFR

Cardiac Troponin I and Amino‐Terminal Pro B‐Type Natriuretic Peptide in Dogs With Stable Chronic Kidney Disease JVIM 2017

121
Q

Does sampling technique affect UPC concentration?

A

No

122
Q

What are possible adverse events associated with the use of darbopoeitin?

A

Hypertension, hyperkalemia, thrombocytosis, seizures, PRCA, vomiting, diarrhea

123
Q

Do calcitonin levels play a role in calcium homeostasis in cats with CKD?

A

No

Blood ionized calcium levels were not sig different between patients with high or low calcintonin levels in the face of hypercalcemia

124
Q

Does 6% tetrastarch result in AKI after 72 hours of administration?

A

No

No pulmonary edema and both LRS and Tetrastarch appear to be reasonable options to support patients witha cute hemorrhage.

(JVIM 2018)

125
Q

What sort of bone changes are noted in canine patients with CKD?

A

Smaller median lacunae size

Resportion cavity density higher

Overall porosity sig higher

mild overall (JVIM 2018)

126
Q

What is the role of FGF-23 and SDMA in geriatric cats?

A

Cats with increased SDMA had sig increased FGF23 and creatinine compared to cats with SDMA within reference range

There is a weak positive correlation between FGF23 and SDMA or creatinine (JVIM 2019)

127
Q

What are low risk breeds for calcium oxalate stone formation?

A

a. am bull dog, am Staffordshire, aussie cattle and sheep, basset, beagle, border collie, boxer, chow, French bull dog GSD, golden/lab retriever, sib huskey (JVIM 2019)

128
Q

What are risk factors associated with calcium oxalate stone formation?

A

Increased ge, male (73% s 27%), breeds: bichon, brussels griffon, cairn, chihuahua, jacks, jap chin, Lhasa apso, maltese, min pin, min schnauzer, pom, yorkie

JVIM 2019

129
Q

What are the general clinical charactteristics, classifications, and surgical outcomes in kittens with phiomosis?

A

Signs: stranguria, preputial swelling

Preputial urethrostoymy and circumferential preputioplasty had good reseolution with a mean follow up time of 1.4 years

130
Q

What is the diagnostic utility of nephrolithotomy for the removal of complicated nephrolits in dogs and cats?

A

Median diamter 2.5 cm; most commonly calcium oxalate

15/16 procedures successful

Tearing of renal structures were the most common - all managed successfully

131
Q

What is the association between urolithiasis and CKD in cats?

A

More likely to have uroliths

No association w nephroliths

132
Q

What comparisons can be made between a ureteral stent and a SUB in cats?

A

Perioperative mortality rate not sig different

Median duration of hospitalization, duration of surgery sig longer for stent vs SUB

Stents also had a higher complication rate, increased likelihood for the need of a second surgery and shorter survival time

133
Q

Is administration of HES expected to increase AKI in cats?

A

When administered cummulative dose of 98.5 ml/Kg over median of 4 days - no

134
Q

What is the clinical value of urinary neturophil gelatinase-associated lipocalin in dogs with kidney disease?

A

UNCR (neutrophil gelatinase-associated lipocalin:creatinine ratio) was lower in prerenal vs progressive CKD or AKI

no diff in UNCR in stable CKD and prerenal azotemia

135
Q

What types of inflammation are known to occur with proliferative urtethritis in dogs?

A

out of 22 dogs - 9 lymphoplasmacytic, 6 lymphoplasmayctic-neutrophilic, 4 pleoellular, 3 neutrophilic

no association w/ type and positive tissue culture or FISH (JVIM 2019)

Fish appears to be superior to prove infection over urine or bladder wall or urethral wall culture

136
Q

What are general considerations when selecting a biopsy tool for kidney biopsy?

A

Needle gauge: 18 gauge inferior to 14 and 16 gauge needle

Other considerations - age, UPC (> 3.5), serum creatinine levels (>5)

137
Q

What is the overall prevelence of proteinuria in healthy elderly dogs?

A

11% - 14% borderline proteinuric, 75% non-proteinuric

19% had persistently increased UPC 0.2

Acvim Journals 2015-2019 (11 decks)

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