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Clinical Pathology > Renal > Flashcards

Renal Flashcards

1
Q

4 major processes in the nephron

A
  1. Glomerular filtration
  2. Tubular resorption
  3. Tubular secretion
  4. Water regulation
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2
Q

What does GFR depend on?

A
  1. renal blood flow
  2. Number of functional nephrons
  3. Hydrostatic pressure
    Rate substances are cleared from plasma via glomerular
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3
Q

Osmolality

A

Concentration of solutes per kg of water

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4
Q

Osmometer

A

Measures number of particles in a volume of water
Not convenient but more accurate

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5
Q

Urine specific gravity

A

Refractometer is convenient but less accurate, Depends on particle weight and how each particle bends light
Prone to interference

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6
Q

Getting osmolality from USG

A

Multiply the last two digits by 30
Rough estimate

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7
Q

ADH

A

Made in hypothalamus and secreted by posterior pituitary. Opens water channels via aquaporin proteins

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8
Q

Stimulation of ADH secretion

A

-Plasma hyperosmolality
-Decreased cardiovascular pressure

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9
Q

Result of ADH

A

Conserve body water to decrease plasma osmolality and increase blood volume

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10
Q

Major events in the proximal CT

A

Removes volume but no change in concentration

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11
Q

Major events in the Descending LOH

A

Removes H2O and increase concentration

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12
Q

Major of events of the ascending LOH

A

Removes solute
Dilution due to decreased concentration

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13
Q

Major events of the distal nephron

A

Removes H2O and increases concentration

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14
Q

What is needed to produce concentrated urine

A
  1. Adequate # of nephrons
  2. Adequate ADH
  3. Distal nephron is responsive to ADH
  4. Hypertonic interstitium in the renal medulla (Urea, Na, Cl)
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15
Q

What happens to the expected values of USG in dehydrated animals

A

Dog> 1.030
Cat> 1.35
Horses and cattle> 1.025

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16
Q

Isosthenuria

A

Urine osmolality and plasma osmolality are equal. In dehydrated pt means kidneys have not concentrated nor diluted the tubular fluid (1.007-1.013)

17
Q

Hyposthenuria

A

Urine osmolality < plasma osmolality.
in dehydrated pt, Kidneys have not actively diluted the tubular fluid. Not renal failure (1.006)

18
Q

Pollakiuria

A

Increased frequency of urine but doesn’t indicate urine volume

19
Q

Ways to assess GFR

A

-Urea nitrogen
-Serum creatinine
-SDMA ( not as common)

20
Q

Ways to asses integrity of glomerular structure

A

-Urine protein
-Urine protein: urine creatinine ration

21
Q

Ability of renal concentration and dilute urine

A

-USG (compare urine and plasma osmolality)
-Water deprivation test

22
Q

Urinalysis assessment

A

-USG
-Chemistry
-Sediment examination
Assesses more than urinary tract

23
Q

Azotemia

A

Increased concentration of Urea unitrogen (BUN or UN) and or creatinine

24
Q

Increased urea formation

A

-High protein diet
-GI hemorrhage
-Disorders that increase endogenous protein catabolism

25
Q

Decreased urea formation

A

-Hepatic failure/shunt
-Malnutrition
-Diuresis

26
Q

Alternate routes of UN for rumenants and horses

A

Saliva, sweat, GI tract
UN is not a sensitive indicator of GFR in those species

27
Q

Important contribution by urea

A

Easily diffuses across most cell membranes and contributes the renal medullary concentration gradient and drives recovery of water/ concentration of urine in the collecting ducts

28
Q

Measuring urea nitrogen

A

Serum (red top) or plasma (green top)

29
Q

What is creatinine

A

Waste product from normal breakdown. Excreted in urine and not resorbed by tubules. The amount formed daily is constant for a given animal. May be proportional to muscle mass

30
Q

Increased Creatinine

A

Does not mean increased muscle catabolism
-Decreased GFR

31
Q

Decreased creatinine

A

May not be clinically significant(needs to be really really low)
-Decreased muscle mass
-Hypoproteinemia

32
Q

UN and creatinine in dogs and cats

A

UN and creatinine increase in parallel when GFR is decreased from renal failure

33
Q

UN and creatinine mismatch in dogs and cats

A

-Prerenal azotemia-> greater increase in UN
-GI hemorrhage-> increased UN
-Anorectic or low protein diet-> decreased UN
-Extremely cachectic-> decreased creatinine

34
Q

Horses and ruminants UN and creatinine

A

Creatinine more specific for renal compromise due to alternate urea metabolism by bacteria

Clinical Pathology (70 decks)

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