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Clinical Pathology > Renal Disease > Flashcards

Renal Disease Flashcards

1
Q

Define oliguria, anuria, and pollakiuria

A

Oliguria - decreased urine production
Anuria - no urine production
Pollakiuria - increased frequency of urination

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2
Q

Where is Urea synthesized?

Describe the process

A

Synthesized in the liver

  • proteins from small intestine broken down to amino acids
  • deaminated in the liver
  • amine group used to make urea
  • urea moved into blood
  • filtered by glomeruli and excreted
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3
Q

BUN concentration varies with the rate of what?

A
  • production by the liver
  • reabsorption by the kidney or GI
  • excretion by the kidney
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4
Q

What are pre-renal causes of decreased BUN?

A
  • decreased urea production (decreased amino acid delivery to liver or hepatic insufficiency)
  • intestinal loss of proteins (protein-losing enteropathy)
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5
Q

What are renal causes of decreased BUN?

A
  • decreased water reabsorption in proximal tubules (increase GFR or tubular flow)
  • osmotic diuresis
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6
Q

How is creatinine produced?

A

endogenous muscle catabolism

- constant rate of production

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7
Q

What is SDMA?

Where does it come from?

A

methlyated form of arginine

released by all nucleated cells

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8
Q

Increases in SDMA indicate what?

A

Renal tubular disease

- increases with 40% loss of renal tubular function

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9
Q

Which substances will alter the USG measurement?

A
  • lipids
  • urea
  • glucose
  • cholesterol
  • hemoglobin
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10
Q

What is Hyposthenuria?

A

USG < 1.007
kidney is taking water out of the body, and putting it into the urine
dilute urine

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11
Q

What causes polyuria?
What does it imply?
What is the USG?

A

inability to concentrate urine
implies loss of 66% functional renal mass
low specific gravity (isosthenuria)

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12
Q

Pre-Renal Azotemia: [BUN], [CREA], and USG

A

increased BUN with or without increased CREA, and increased USG

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13
Q

What are the causes of pre-renal azotemia?

A
  • decreased GFR (dehydration, shock, cardiac insufficiency, decreased renal blood flow)
  • increased urea production (upper GI bleed, high protein diet)
  • increased CREA production (increased muscle mass)
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14
Q

Renal Azotemia: [BUN], [CREA], and USG

A

increased BUN and CREA, decreased USG

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15
Q

What happens in renal azotemia?

A
  • implies loss of 75% functioning nephrons
  • results in decreased GFR
  • loss of concentrating ability: isosthenuria
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16
Q

Post-Renal Azotemia: [BUN], [CREA], and USG

A

increased BUN and CREA, variable USG

17
Q

What are the causes of post-renal azotemia?

A

obstruction of urinary outflow

  • urolithiasis
  • uroabdomen
18
Q

What is the cause of pre-renal proteinuria?

A

increase in small protein in the blood

19
Q

What are the causes of renal proteinuria?

A
  • damage to glomeruli (albumin first to leak through, followed by antithrombin)
  • damage to tubules (filtered proteins not reabsorbed)
20
Q

What are the causes of post-renal proteinuria?

A
  • hemorrhage into genitourinary tract

- inflammation

21
Q

Effect of hypercalcemia on renal function

A
  • impairs urine concentrating ability causing PU, by affecting ADH receptors
  • leads to mineralization of renal tubules
22
Q

What are the causes of hyperphosphatemia?

A
  • when GFR is < 25%, P excretion is impaired
  • decreased serum Ca leading to hyperparathyroidism
  • mineralization of soft tissues (when Ca X PO4 > 70)
23
Q

What are the major indicators of uroabdomen?

A
  • hyperkalemia
  • hyponatremia
  • peritoneal CREA greater than 2X serum CREA
24
Q

Acute Renal Failure patient presentation

BCS, GI, renal, neuro

A

acute onset of clinical signs

  • good BCS
  • anorexia, vomiting, diarrhea, halitosis
  • oliguric to anuric
  • depressed
25
Q

What are the typical causes of ARF?

A
  • toxins
  • ischemia
  • infection
26
Q

What are the main findings in the bloodwork/urinalysis of a patient with ARF?

A
  • abrupt decrease in GFR (oliguria or anuria)
  • variable USG
  • azotemia (fast development)
  • possible hyperkalemia and acidemia
27
Q

Chronic Renal Failure patient presentation

BCS, GI, renal, neuro, other

A

slow onset of clinical signs

  • poor BCS
  • anorexia, vomiting, diarrhea, halitosis
  • polyuric
  • depressed
  • hypertension
28
Q

What are the main findings in bloodwork/urinalysis of a patient with CRF with a GFR < 20-25% of normal?

A
  • non-regenerative anemia
  • dehydration
  • azotemia
  • possible hyperphosphatemia
  • metabolic acidosis
  • normal to hypokalemia
  • polyuria, isosthenuria
29
Q

What are the main findings in bloodwork/urinalysis of a patient with CRF with a GFR < 5% of normal?

A
  • non-regenerative anemia
  • marked dehydration
  • marked azotemia
  • hyperphosphatemia
  • metabolic acidosis
  • hyperkalemia
  • oliguria to anuria, isosthenuric
30
Q

What are the laboratory findings in an animal with glomerulonephritis?

A
  • hypoproteinemia (hypoalbuminemia, normoglobulinemia)
  • proteinuria (albuminuria)
  • azotemia, isosthenuria
31
Q

What is nephrotic syndrome?

What are the signs?

A

protein-losing nephropathy leading to abdominal transudation

  • hypoalbuminemia
  • hypercholesterolemia
  • edema/abdominal effusion
  • hypercoagulable state (loss of antithrombin)

Clinical Pathology (11 decks)

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