Renal 2018.2019 Flashcards
JAVMA 2019- Pyelocentesis is it more likely to be positive than an urine culture?
No: Not indicated to culture for ureteral obstruction as the same
JAVAM 2019 – Descried antegrade pyelography
Needle 22 ga 1.5 inch and add idonated postivie contrast then take radiographs
Good diagnostic tool for stricture/obstruction of ureters
with 1/49 severe complications
JVECC 2019 – What is the incidence of bacteruria in UO prior to and after catheterization
0 positive at time of placement
4/31 (13%) at 24 hours regardless of when u-cath removed
Urine pulled from line and may not represent clinical UTI
JVAMA 2019 – Does chondroitin sulfate increase when orally administered in the urine
When administered twice daily increased urine chondroitin sulfate. Does not increase more when given more frequently and does not buildup over one week.
AJVR 2019 What is the effect of glucosuria on USG
Glucosuria slightly increased USG, less so in more concentrated urine.
Stasticially but not clinically signficiant at all amounts of urine
JAVMA 2019 How does bladder flush effect rUO in hospital
Did not alter the rUO rate in hospital. Underpowered to determine differend from 19% (no flush) to 13% flush
Flushed til clear and used two different catheter sizes
JAVMA 2018 Ultrasound utility in diagnosis of ureteral obstruction in cats
Highly sensitive for ureteroliths but not strictures
good diagnostic tool. Strictures and blood clots misidentified as stones
JAVAM 2019 Balloon dilation of the urethra for UO due to urethial carcinoma
Successful in 9/12 cases on the first time. Caused dysuria. Fluroscopic guidance needed.
JVECC 2019 post morteum study of renal tubular vacularization what was noted to increase severity
Worse with increased creatinine at presentation and increasing doses of HES 670/0.75. Mannitol did not effect.
JVECC 2019 In a model of hypovolemia in greyhounds what fluid increased AKI biomarkers (uNGAL)
4% succinylate gelatin increased.
Fresh whole blood, HES 130/0.04, isotonic crystalloid no significant difference
JAVAM 2019 how can cystoscopy/cystourethroscpy treat benign macroscopic hemauria- list three differentials.
abalate
Hemangioma, angioma, telangiectasia
JVIM 2019 How can the USG be used to predict a UPC and how does bacteria play a role
With protienuria on dipstick the USG can not be used to determine the UPC.
Clear bacteria prior to interpreting UPC
JVIM 2019 What are the risks for Candida UTI in dogs and cats
On antibiotics in the previous 30 days.
Cats: History of lower urinary tract disease
NO EFFECT: hospitalization, catheterization, and immunosupresion
JIVM 2019 What is the variability in USG in first AM samples by dogs
Over the two weeks 0.015
Within in each week 0.009 and 0.010
JVIM 2019 What is the hemostatic function observed in dogs with AKI
AKI: have decreased platelet aggregation and display type II VW disease phenotype
Mechanism is attributed to abnormalities in platelet adhesion
JVIM 2019 What was noted with citrate in membrane therapeutic plasma exchange
Dogs with renal impairment not liver have higher accumulation
Hypocalcemia noted but did not note severe signes
JVIM 2019 What laboratory values changed in membrane therapeutic plasma exchange
Decreased protiens fibrinogen, bilirubin, urea, creatinine
JVIM 2019 What was the percentage of positive urine cultures in dogs with CKD and which were more likely to be positive.
32% positive only 8% where clinical
Female and isothenuria more likely to be positive
Presence of WBC on dipstick and bacteria more likely positive
How do male dogs have natural bacteriostatic properties in urine
Zinc in prostatic secretions
JVIM 2019 Did the addition of meloxicam to phenoxybenazimine and alprazolam change the rUO
No difference in the two groups
5Fr cath
JVIM 2019: What are the limitations of the sedivue
Good for RBC, WBC, Ca Ox, Struvite
No good for epithelial cells
JVIM 2019 in comparission to creatine how do SDMA and Cystin C as markers of decreased GFR.
Creatinine and SDMA good markers for decreased GFR (performed equally) but Cystin C is not
If one is elevated/normal (Cr/SDMA) Others can be good indicator if true disease
JVIM 2019 What dogs are at higher risk of developing Calcium oxalate stones
Small breed dogs specifically MN schaunzer, bichon frise
8.4 yrs +/- 2.8 yrs
JVIM 2019 How does fibroblast growth factor 23 change with SDMA in non azotemic geriatric cats
FGF 23 increased when SDMA increases also has higher creatinine
JVIM 2019 what is the proposed underlying cause/contributor to proliveritive cystits in dogs
Bacteria in the tissue may be part of underlying causes. Urine and tissue cultures likely underrepesent as staining was positive
JVIM 2019 what biomarker is the best ad correling renal function in dogs undergoing IVF or IHD with CKD
SDMA correlates better than creatinine to severity of CKD for dogs with IVF or IHD
Although SDMA is dialysized, less is able to be reduced with increasing severity of CKD.
JVIM 2019: In dogs how did uNGAL compare in progressive CKD, stable CKD, and pre-renal azotemia
Increased most significantly in dogs with progressive CKD.
no stat difference in stable CKD or pre-renal azotemia
NEJM 2009 RENAL trial. What was the outcome difference for high intensity CCRT vs Low intensitiy CCRT
There was not difference in mortality at 90 days. Complications occured in both groups although disequilibrim occured mostly in the high intensidty
JVIM 2012 What was the outcome of Level 2 AKI for hospitalizations patients and when did it affect oucome
Level 2 Crea 1.6 mg/dl and Change of 0.3 mg/dl
If observed on days 2-7 in dogs and 3-7 in cats 3 times more likely to die in 30 and 90 days.
JVIM 2011 What were the histologic lesions noted with pyometra in the kidneys
UPC> 0.5 tubulointerstitial neprhritis
UPC > 1.0 glomerulosclerosis
None had glomuleronephritis as previously thought
JFMS 2011 What resulted in more non survivors and what was noted in cats that had a higher rUO
Ionized calcium higher (1.08) in survivors vs. Non-survivors (0.88)
Recurrence higher with lower pH at presentation
JVIM 2011 How did albuminuria, survivor predictor index score and c-reactive protien associate with survival in critically ill dogs
C-Reactive protien is not an predictor of survivial
Lower albuminuria resultes in survivial
SPI score also associated with survivial
JVIM 2015 What led to an increased survival in dogs with AKI
Increased GFR, Increased urine production. and decreasing functional clearance of Na (extraction ratio used).
K excretion less susceptible likely due to DCT less damage compared to PCT
JAVMA 2018 what increased the risk of rUO in the standard care group
Increasingly abnormal urine color at time of removal stat increased rUO at 30 days.
JAVMA 2018 how did the outpatient care group compare to the standard care group.
Standard care best 11 % rUO
Outpatient cath 31% rUO
JAVMA 2018 What is the diagnostic utility of renal FNAs
72% were considered diagnositics
Neoplasia similar sen/spec for other organs in body
78/50
JAVMA 2018 what percenterage of dogs with Bacteruria in CKD dogs
18% with 45% of those subclinical and 40% with pyelonephritis
JAVMA 2018 how long did the cystotomy sites remained thickened and when could hyperechoic foci be detected
Noted for up to 3 months.
Hyperechoic foci were noted in 11/18 dogs at a mean of 17 days post surgery
JAVMA 2018 How is canine urine samples affected by refrigeration with and without TSB
No stat difference in refrigerated vs direct submisison but there were 2 less that grew bacteria.
TSB refrigerated was stat different than no refrigeration and should not be used.
JAVMA 2018 how does microscopic blood contamination affect UPC and dipstick
May increase UPC
Also affects bilirubin, ketones, pH, USG, but does not alter glucose
JAVMA 2018 What is the prognosis with uroabdomen and what was noted to result in decreased survivial
79% survival to discharge. Serum creatinine was not associated with survival
4/5 medically managed successfully
JVIM 2018 How was hyperthyroid related to SDMA prior to i131 treatment in cats
Increased pretreatment SDMA highly specific 98% but not specific.
Hypterthyroid cats that became hypothyroid were azotemic.
JVECC 2015 What are the two criteria used for AKI in humans
RIFLE: risk, injury, failure, loss, end stage
KIDGO: Kidney disease improving global outcomes
JVECC 2015 How is uNGAL associated with AKI
uNGAL increases 12 hrs before serum NGAL and creatinine in AKI
JVECC 2015 How do chloride rich fluids contribute to AKI
Activates the macula densa and induces renal afferent arteriole vasoconstriction
JVECC 2015 What is the eitology of Sepsis induced AKI
ischemia/reprofusion Inflammation oxidative stress (ROS) Epithelial dysfunction- renal tubular dysfunction; Activation of tubular glomerular feedback sublethal cellular injury
