Renal Disease Parameters Flashcards
what are the clinical signs associated with acute renal disease
oliguria
severe metabolic disease
proteinuria
granular casts
what kind of proteinuria is associated with acute renal disease
tubular
what can cause chronic renal insufficiency
chronic sustained reduction in renal function and/or structural change
CKD typically includes patients with…
tubulointerstitial nephritis
primary glomerular disease
what are some clinical signs associated with CKD
azotemia
PU/PD
Non-regenerative anemia
acidosis due to loss of bicarb
*increase Ca in horses
describe the USG in end stage renal disease
USG in or near isosthenuric range
what are the clinical signs of end stage renal disease
isosthenuric
marked azotemia
metabolic acidosis
increased K and PO4
what causes a post-renal azotemia
obstruction of urinary outflow tract
release of vasoactive substances
break in urinary system
what are 3 disorders to cause post-renal azotemia
calculi
neoplasia
feline lower urinary tract disease
true or false:
the USG in post-renal azotemia ia variable
true
true or false:
post-renal azotemia can occur with no decrease in GFR
true
what analytes are usually marked in post-renal azotemia
K
Na, Cl
how does proteinuria contribute to progression of CKD
promoting tubulointerstitial inflammation
fibrosis
atrophy
true or false:
severity of proteinuria significantly correlated with renal survival times
true
what can be used to measure proteinuria
dipstick
what is the qualitative way to measure proteinuria
dipstick
what is the quantitative way to measure proteinuria
urine protein : creatinine ratio
when should a urine protein : creatinine ratio not be done
urine is visibly pink
what will a urine protein: creatinine ratio tell you
if there is significant renal tubular or glomerular protein loss
how can you tell if there is tubular renal protein loss with a urine protein: creatinine ratio
<1 is usually tubular
how can you tell if there is glomerular disease with a urine protein: creatinine ratio
> > 1
which type of proteinuria is not permanent
pre-renal
what type of proteinuria is associated with pre-renal
over flow
what type of proteinuria is associated with renal
tubular
interstitial
glomerular
what type of proteinuria is associated with post renal
secretory / post glomerular
what can be seen in pre-renal (preglomerular) over flow proteinuria
small proteins in blood
hemoglobin
myoglobin
bence jones proteins
what can also be seen in the urine with a proteinuria due to tubular disease
glucosuria
what are the 3 things seen with renal proteinuria due to tubular disease
glucosuria
azotemia
decreased USG
what can interstitial renal proteinuria cause
acute interstitial nephritis
describe the pathogenesis of acute interstitial nephritis
causes exudation of proteins into the urinary space
what things can causes glomerular renal proteinuria
immune complex glomerulopathy
amyloidosis
hypertension
infectious disease
neoplasia
what can signify a glomerular renal proteinuria
high levels of proteinuria due to albumin leakage
what is the main pathogenesis of glomerular renal proteinuria
immune complex disorders
how would you be able to classify a glomerular disease
significant albumin present in urine
decreased serum albumin
edema
hypercholesterolemia / nephrotic syndrome
what are some possible outcomes with glomerular disease
concurrent loss of antithrombin III
hypercoagulable state
DIC / intravascular thrombosis
in cases of toxic renal azotemia, when does azotemia occur
within hours
what are some main causes of toxic renal azotemia
anti-freeze
grapes/ raisins
easter lily toxicosis
what is seen with cholecalciferol toxicity
acute toxicosis
12-72 hour changes
increased:
phosphorus
calcium
azotemia
USG = isosthenuric
what are some of the ethylene glycol metabolites associated with antifreeze toxicity
aldehyde
glycolic acid
oxalate
what type of crystals are seen with ethylene glycol toxicosis
calcium oxalate crystal formation within renal tubules
what what a chemistry look like with ethylene glycol toxicosis
severe azotemia
increased PO4
increased K
decreased calcium (due to crystal formation)
what metabolic conditions does antifreeze toxicosis cause
metabolic acidosis
increased anion gap
isosthenuria
what syndrome affects the proximal renal tubule and causes abnormalities in Na, glucose, Ca, PO4 and amino acid retention
fanconi syndrome
when are transient cases of fanconi syndrome often seen
cases with toxins and drugs that affect the proximal renal tubule
what are some breeds in which fanconi syndrome is inherited
basenjis
norwegian elkhounds
schnauzer
shetland sheepdog
