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VETM 442 > Renal > Flashcards

Renal Flashcards

1
Q

list some functions of the kidney

A
  • eliminate metabolic waste
  • water and electrolyte balance
  • acid base regulation
  • endocrine (aldosterone, erythropoietin, vitamin D/calcitriol)
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2
Q

what are the 3 processes that control H2O, electrolyte, and water excretion in the kidney?

A
  • glomerular filtration
  • tubular resorption
  • tubular secretion
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3
Q

what is glomerular filtration rate?

A

the rate at which blood is filtered through all of the gloermuli and thus the measure of the overall renal function

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4
Q

what are some of the freely filterable substances that make it through the glomerulus?

A
  • small things less than 3.4nm
  • positively or neutrally charged things (basement membrane is neg charged)
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5
Q

reabsorption happens in the ______ and secretion happens in the _____

A

proximal tubules
distal tubules

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6
Q

tubular disease will cause what 3 things?

A
  • retention of metabolic wastes
  • acid base/electrolyte disturbances
  • inability to concentrate/dilute urine
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7
Q

glomerular disease results in

A

leakiness

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8
Q

renal concentrating ability rewuires what 3 things?

A
  • renal interstisium (to create necessary concentration gradients)
  • functional tubules
  • ADH as well as ADH responsiveness
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9
Q

what is required to concentrate vs dilute the urine?

A

concentrate: ADH and a concentration gradient
dilute: sufficient filtered Na and Cl and active transport in ascending limb

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10
Q

what is the normal range for a USG?

A

1.001-1.065

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11
Q

what are the USGs for:
- adequate renal concentrating ability
- isosthenuria (unable to dilute or concentrate)
- hyposthenuria (kidney cannot dilute)

A

adequate: more than 1.030/1.035/1.025
isosthenuria: 1.008-1.012
hyposthenuria: less than 1.008

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12
Q

true or false: you can tell acute kidney disease from chronic kidney disease on bloodwork alone

A

false! you need clinical signs and history and other lab findings!!!

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13
Q

what are the two main markers of kidney/renal disease?

A

BUN and creatinine

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14
Q

where does BUN come from? why is it in urine?

A

BUN/urea is a nitrogenous waste product made in the liver from CO2 and ammonia via the urea cycle and is excreted exclusively in urine, and is filtered by the glomerulus

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15
Q

increased blood urea concentrations are seen with:

A
  • decreased GFR
  • increased protein digestion
  • protein catabolism/fever
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16
Q

a decrease in blood urea concentrations are seen with:

A
  • decreased production (liver failure or PSS)
  • decreased protein diet/malnutrition
  • increased excretion (polyuria)
  • urea cycle enzymes deficiencies SUPER RARE
17
Q

what is creatinine and why is it a renal marker?

A

it is produced in skeletal muscle at a constant rate and is a normal result of muscle metabolism, and it is excreted by the kidney (not the same as creatine kinase)

18
Q

what are the 3 causes of azotemia with the respective USG values?

A
  • pre renal: impaired renal blood flow or decreased perfusion possibly due to decreased blood volume. USG>1.030
  • renal: intrinsic renal disease. USG 1.008-1.012
  • post renal: urinary tract obstruction, diagnosed heavily on clinical signs and history, etc, not USG
19
Q

what is uremia?

A

refers to clinical signs associated with renal failure like vomiting, diarrhea, weakness, diarrhea, weakness, ammonia breath, etc

20
Q

renal failure occurs when _____% of functional renal mass is lost and azotemia develops

A

66-75

21
Q

what should you take into account when interpreting creatinine values?

A

muscle mass

22
Q

true or false: some healthy dogs can have small amounts of albumin in urine

A

true, can have trace to 1+ in concentrated urine, BUT presence in dilute urine is ALWAYS a concern and should be investigated

23
Q

what are the 3 types of proteinuria?

A
  • prerenal: increased proteins in the blood going to be filtered thru glomerulus
  • renal: glomerular damage and decreased permeability, allows protein to pass through
  • post renal: hemorrhage or inflammation in he lower urinary tract like with a UTI
24
Q

hypoalbuminemia is most often associated with what kind of proteinuria?

A

renal proteinuria

25
Q

what is a urine protein creatinine ratio and why do we use it?

A

a test that evaluates loss of protein relative to loss of creatinine, used to help confirm a renal proteinuria (true problem with the kidney), glomerular proteinurias tend to have the most dramatic increases in UPC ratio

26
Q

what are 3 key takeaways in regards to the urine protein: creatinine ratio?

A
  • proven persistent proteinuria
  • need concurrent bloodwork results
  • if considering doing a UPC, ensure sediment is not active
27
Q

with ethylene glycol toxicity, which is the bad crystal, the Ca-oxalate monohydrate crystals or the Ca-oxalate dihydrate cystals?

A

the monohydrate crystals. the dihydrate ones can be normal to have

28
Q

how does ethylene glycol affect blood glucose levels?

A

ethylene glycol may inhibit glycolysis can can stimulate gluconeogenesis and cause a hyperglycemia

29
Q

when you have a hypochloremia without a concurrent hyponatremia (normal sodium), what does this mean and what should you think about?

A

a low Cl with a normal Na means there is a disproportionate hypochloremia, which is indicative of a metabolic alkalosis which can be due to vomiting

30
Q

UPC ratio helps you determine what?

A

if the renal disease is glomerular, or tubular/ greater than two indicates glomerular disease, less than two indicates tubular disease

31
Q

what are some characteristic findings on bloodwork for protein losing nephropathy?

A
  • proteinuria
  • selective hypoalbuminemia
  • hypercholesterolemia (compensate oncotic pressure??)
  • not all patients are azotemic
  • decreased ATIII (peeing it out), hypercoagulability
32
Q

a ratio of abdominal fluid creatinine to serum creatinine of greater than 2:1 is indicative of

A

uroabdomen

VETM 442 (18 decks)

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