Renal Diseases

Question 1

is creatinine or BUN high molecular weight?

Answer 1

creatinine

Question 2

what type of environment does the inner medullary tissue operate in?

Answer 2

hypoxic environment

Question 3

why can you have false positives on dipsticks for protein?

Answer 3

alkaline urine: pH 8.5

Question 4

what prevents crystals aggregating into uroliths in horse urine?

Answer 4

mucus

Question 5

what is azotemia?

Answer 5

abnormally increased concentrations of nonprotein nitrogenous substances in blood

Question 6

what do we look at in urine for renal biomarkers?

Answer 6

uGGT
protein:creatinine ratio
urine specific gravity

Question 7

where is creatinine filtered?

Answer 7

in glomeruli

Question 8

what does symmetric dimethylarginine correlate with?

Answer 8

GFR
serum creatinine

Question 9

what is influence of extrarenal factors like on symmetric dimethylarginine?

Answer 9

low influence of extrarenal factors

Question 10

what is renal failure?

Answer 10

inability to concentrate/dilute urine

Question 11

what is structural kidney disease diagnosed with?

Answer 11

palpation/imaging
can/cannot precede alterations in function

Question 12

what is acute kidney injury?

Answer 12

serum creatinine increase by 0.3 mg/dl
increase in creatinine >1.5 x baseline
oliguria <0.5 ml/kg/hr for 6 hours

Question 13

what causes damage to epithelial cells?

Answer 13

ischemia
nephrotoxins

Question 14

what is chronic kidney injury?

Answer 14

creatinine >2.0 mg/dl
longer than 3 months

Question 15

what structural changes occur with chronic kidney disease?

Answer 15

glomerular basement membrane changes
expanded mesangial matrix
glomerulosclerosis
tubulointerstitial fibrosis

Question 16

what does thyroidization in CKD result in?

Answer 16

hyaline casts

Question 17

what can cause dehydration or a hypotensive event that can lead to kidney injury?

Answer 17

excessive sweating with exercise
colic or colitis
anaphylactic event
endotoxemic event

Question 18

what are the common causes of renal disease in horses?

Answer 18

colic
colitis
aminoglycoside antibiotics
NSAIDs

Question 19

what do aminoglycosides cause in the kidneys?

Answer 19

accumulate in proximal tubular epithelial cells
acute tubular necrosis in proximal tubules

Question 20

how do NSAIDs cause renal damage?

Answer 20

inhibition of prostaglandins
exacerbate ischemia, specifically in medulla: medullary necrosis
metabolites may have direct toxicity when excreted

Question 21

are COX-2 selective NSAIDs more protective of the kidneys?

Answer 21

no

Question 22

what is the pathophysiology of acute renal failure in rhabdomyolysis?

Answer 22

renal vasoconstriction
toxic effect on renal tubules
cast formation

Question 23

if there is no response with oliguria in 72 hours, what is the prognosis?

Answer 23

grave

Question 24

what does furosemide do?

Answer 24

inhibits Na/K/2Cl transport
decreases metabolic requirements of kidneys

Question 25

when is blood urea nitrogen low?

Answer 25

building muscle

Question 26

how much of the cardiac output do the kidneys receive?

Answer 26

20%

Question 27

what makes horse urine turbid?

Answer 27

calcium carbonate and oxalate crystals

Question 28

what has traditionally been used as a biomarker of glomerular filtration rate?

Answer 28

creatinine

Question 29

what does a small increase in serum creatinine indicate in early kidney disease?

Answer 29

large decrease in GFR

Question 30

what does a large increase in serum creatinine indicate in advanced kidney disease?

Answer 30

smaller decrease in GFR

Question 31

does structural kidney disease always produce alterations in function?

Answer 31

not always

Question 32

can functional kidney disease occur with no structural changes?

Answer 32

yes

Question 33

what are some pre-renal causes of azotemia?

Answer 33

decreased perfusion: dehydration, hypovolemic shock, cardiac failure

Question 34

what are some causes of decreased GFR (renal azotemia)?

Answer 34

renal injury
inflammatory changes
toxic insult
infectious diseases

Question 35

what can cause damage to epithelial cells and acute tubular necrosis?

Answer 35

ischemia
nephrotoxins

Question 36

is a biopsy necessary to diagnose chronic kidney disease?

Answer 36

no: lab and history
can help with cause

Question 37

what is high in chronic kidney disease?

Answer 37

calcium
azotemia
potassium
metabolic acidosis

Question 38

why is hypercalcemia seen with chronic renal disease?

Answer 38

decreased urinary excretion
increased bone turnover (PTH)

Question 39

what are some toxins that can cause kidney disease?

Answer 39

antibiotics: gentamicin, oxytetracycline
NSAIDs: flunixin, firocoxib, phenylbutazone
other: red maple, vitamin K3, vitamin D

Question 40

what are the less common causes of renal disease?

Answer 40

hemorrhage
exhaustive exercise
rhabdomyolysis

Question 41

is a substantial amount of AKI due to iatrogenic causes?

Answer 41

yes

Question 42

do reagent strips differentiate between myoglobinuria, hemoglobinuria, and hematuria?

Answer 42

no

Question 43

why does renal vasoconstriction occur with rhabdomyolysis?

Answer 43

damaged myocytess sequester fluid: hypovolemia
activation of renin-angiotensin system

Question 44

what rate of fluids should you use if the animal is drinking?

Answer 44

40-80 ml/kg/day at most
20-40 ml/kg/day until creatinine normal

Question 45

how can you worsen an AKI with fluids?

Answer 45

hypervolemia

Question 46

what is a risk with mannitol?

Answer 46

fluid overload
overdose can induce AKI
hyperkalemia

Question 47

what should you monitor for on low-dose dopamine?

Answer 47

tachycardia
hypertension