Normal kidney function

Question 1

What 3 hormones are produced by the kidneys?

Answer 1

Erythropoietin
Vitamin D (activated in kidney)
Renin

Question 2

How does phosphate alter with a decreased GFR (for small animals and horses?

Answer 2

Phosphate increased (small animals)
Phosphate decreased (equine)

Question 3

What USG in cats or dogs suggests renal disease?

Answer 3

<1.030 in dogs

<1.035 in cats

Question 4

Is protein normal in urine?

Answer 4

Only 1+

Question 5

What may increased protein in the urine suggest?

Answer 5

Glomerular damage

Or protein overload

Question 6

Glucosuria can be seen with serum glucose >10mmol/l in dogs or >16mmol/l in cats. What is renal glucosuria and what syndrome is it seen in?

Answer 6

Glucose in urine but serum glucose normal

Fanconi’s syndrome

Question 7

What is Fanconi’s syndrome and what breed is predisposed?

Answer 7

Disease of proximal tubules
Substances normally absorbed into the blood by the kidneys are released into urine instead (e.g. renal glucosuria)
Basenji’s predisposed

Question 8

What is the normal pH of urine?

Answer 8

5-5.7

Question 9

What may cause the pH of urine to change?

Answer 9

Acidic urine - metabolic acidosis

Alkaline urine - UTI

Question 10

What urinary casts indicate tubular damage in cats?

Answer 10

Granular, cellular and waxy casts

Hyaline casts normal!

Question 11

What is the most accurate way to assess GFR?

Answer 11

Iohexol clearance assay

Question 12

An iohexol clearance assay is the most accurate way to assess GFR. Name 2 other ways in which GFR can be estimated, and which is more accurate?

Answer 12

SDMA - more accurate

Urea and creatinine - less accurate

Question 13

Azotaemia (an increase in urea and creatinine) suggests decreased GFR. Azotaemia is only apparent when what % of nephrons are lost?

Answer 13

75+ %

Question 14

Pre-renal azotaemia is due to decreased kidney perfusion or increased urea production. How is urine concentration affected?

Answer 14

Concentrated urine
(Pre-renal azotaemia = only urea increased)

Question 15

How does renal azotaemia affect urine concentration?

Answer 15

Isosthenuria

suboptimal GFR

Question 16

Uraemia is a syndrome seen with failing kidneys. What symptoms may be seen with uraemia?

Answer 16

Vomiting
Anorexia
Lethargy
Metabolic acidosis

Question 17

What is nephrotic syndrome? (How happy are pigs?)

Answer 17

Hypoalbuminaemia
High cholesterol
Ascites
Proteinuria

Question 18

What is xeroztomia?

Answer 18

Dry mouth seen with kidney disease

Question 19

Which kidney is palpable in dogs?

Answer 19

Left only

Question 20

What affect does anti-diuretic hormone have on urine concentration?

Answer 20

Concentrates urine

Lack of ADH - dilute urine

Question 21

What effect does aldosterone have on blood pressure?

Answer 21

Causes water reabsorption - increases blood pressure

Question 22

What are the differentials for hypercalcaemia? (Hardison)

Answer 22

Hyperparathyroidism/hyperthyroid
Addison's, vitamin A
Renal disease, raisins
D - vitamin D
Idiopathic/inflm/infectious
S - schistosomiasis
O - osteolysis
N - neoplasia, nutritional