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URI > Renal failure > Flashcards

Renal failure Flashcards

1
Q

Describe incidence acute kidney injury

A
  • Rare
  • All species
  • Poor prognosis
  • 3 levels
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2
Q

What are the 3 levels at which acute kidney injury can occur?

A
  • Pre-renal
  • Renal/intrinsic (worst prognosis)
  • Post-renal
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3
Q

What may cause pre-renal acute kidney injury?

A
  • Loss of blood, fall in perfusion
  • e.g. haemorrhage
  • Need to support underlying cause (hypovolaemia)
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4
Q

What causes intrinsic AKI?

A
  • Many nephrotoxins

- Lillies, anti-freeze, NSAIDs

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5
Q

What can cause post-renal AKI?

A
  • Blockage leading to back flow
  • Slows GFR and build up urea
  • e.g. renal stones
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6
Q

What are the physiological effects of AKI?

A
  • Loss of efficient excretion and homeostasis

- Uraemia, hyperkalaemia and acidosis

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7
Q

What are the clinical findings in AKI?

A
  • Rapid and progressive
  • Very sick (high uraemia)
  • Large painful bladder/kidneys
  • Lethargy
  • Depression
  • Anorexia
  • Vomiting
  • Dehydration
  • No urine (anuria) as no GFR
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8
Q

Describe chronic kidney disease

A
  • Common
  • Cats > dogs > horses
  • Prolonged (>2 months) loss of renal tissue
  • Progress - chronic interstitial nephritis
  • Irreversible
  • Prognosis variable
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9
Q

When are clinical signs apparent in chronic kidney disease?

A
  • Loss of 70% of renal tissue

- USG can decrease early on

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10
Q

What are the clinical signs of chronic kidney disease?

A
  • Weight loss
  • Poor body condition
  • Loss of muscle mass
  • Increased water intake
  • Decreased appetite
  • Ventroflexion (cats)
  • PU/PD
  • GI signs
  • Small knobbly kidneys
  • Non-regenerative anaemia
  • Blindness
  • Uraemia, azoaemia, dehydration
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11
Q

Why does polydipsia occur in chronic kidney disease?

A
  • Hyperfiltration in remaining nephrons
  • Higher GFR, reduced reabsorption, increased loss of water
  • More urine produced
  • Need to replace loss by drinking more
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12
Q

Why does ventroflexion occur in chronic kidney disease?

A
  • Fall in potassium
  • Cats due to lack of nuchal ligament
  • Fatigue as need potassium for muscle contraction
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13
Q

Why do gastrointestinal signs occur with chronic kidney disease?

A
  • High urea in blood irritates stomach lining

- Vomiting and nausea occur

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14
Q

Why does non-regenerative anaemia occur with chronic kidney disease?

A
  • EPO produced in kidneys, loss of kidney leads to loss of EPo
  • EPO trigger maturation of RBCs so will get anaemia with kidney disease
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15
Q

Why can blindness occur with chronic kidney disease?

A

Increased blood pressure can lead to burst blood vessels in back of retina

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16
Q

What is the difference between acute and chronic kidney disease?

A
  • Acute very quick, chronic gradual
  • In both signs shown renal insufficiency occurs (33% of kidney left)
  • In chronic likely to be skinny due to loss of protein, rise in blood pressure can lead to blood clots in eye
17
Q

What are the features of a renal diet?

A
  • Reduced phosphate
  • High quality protein
  • Fat soluble vitamins
  • Low sodium
  • Potassium
18
Q

What treatment options are available for kidney disease?

A
  • Calcium channel blockers, vasodilation of efferent arterioles, reduces filtration pressure
  • Decrease GFR (fortekor), in order to retain protein
  • Potassium supplementation
  • Correct acidosis potentially (bicarbonate solution)
  • Synthetic EPO to correct anaemia
19
Q

List some clinical pathological features of renal dysfunction

A
  • PU/PD
  • Weight loss
  • Hypertension
  • Vomiting, loss of appetite
  • Blindness
  • Anaemia
20
Q

Why does hypertension occur with chronic kidney disease?

A
  • Released renin due to perceived poor perfusion in kidney (damaged areas not perfused)
  • Release of renin, activation of RAAS
  • Increase in blood pressure
  • Further damage to remaining nephrons

URI (15 decks)

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