Renal/Urinary Flashcards
Why are IVPs not helpful in animals with ureteral obstructions?
poor filling of obstructed kidney
risk of nephrotoxicity
Name 4 anti-spasmodics and their MOA
- Prazosin: alpha1 nonselective adrenergic antagonist
- Tamsulosin: alpha1a antag
- Verapamil: CCB
- Papverine: PDE inhibitor
At what stage of AKI does irreversible damage occur?
maintenance
What are 4 methods to measure GFR?
Iohexol clearance
Endogenous creatinine clearance
Scintigraphy
Inulin clearance
5 infectious causes of AKI?
RMSF Borrelia burgdorferi Babesia Leishmania Leptospirosis
2 scoring systems for AKI?
RIFLE (risk injury failure end stage kidney disease) & AKIN (acute kidney injury network)
T/F: the RIFLE score has been shown to perform better than the AKIN scoring system for AKI
False- there has been similar performance
T/F: a relative increase in plasma creatinine of >150% or 0.3 mg/dl increase from baseline is associated with increased in-hospital mortality with AKI?
TRUE!!
Name some causes of hemodynamic AKI
decreases in renal perfusion or excessive vasoconstriction; can be rapidly reversible if inciting cause is eliminated
Name and describe the 4 phases of AKI
- Initiation- first stages of renal injury; interventions at this phase may prevent progression to more severe injury; biochemical values may be normal
- Extension- cellular injury progresses to cell death; biochemical and clinical manifestations become evident
- Maintenance- cell death and regeneration occur simultaneously; removal of inciting cause will not reverse damage but may allow balance to shift in favor of parenchymal regeneration
- Recovery- improvement in GFR and tubular fxn; may last weeks to months
Name and describe the 4 stages of VAKIN staging scheme
Stage 0- increase 300% or absolute creat value >4
List 4 common laboratory abnormalities in CKD
- Increased BUN
- Increased creatinine
- Hyperphosphatemia
- Hypercalcemia
- Increased CK
- Hypokalemia
- Metabolic acidosis
Name three reasons a patient with CKD might be anemic
- Decreased RBC life span
- Decreased EPO production
- Blood loss from uremic ulcers
What is “glomerulotubular imbalance?”
This is a phenomenon in which patients with CKD present with azotemia and concentrated urine (USG > 1.030). The pathophysiology has not been determined.
List 4 breeds that have congenital renal dysplasia
Lhasa apso, Shih tzu, Standard poodle, Wheaten terrier, Chow, Alaskan malamute, Miniature schnauzer, Dutch kooiker
List 5 breeds that have familial primary glomerulopathies
Samoyed, English cocker, English springer, Bull terrier, Dalmatian, Doberman, Mastiff, Newfoundland, Rottweiler, Pembroke welsh corgi, Beagle, Wheaten terrier
List 3 breeds that have congenital polycystic kidney disease
Bull terrier, Cairn terrier, Westie
List 3 breeds that have familial amyloidosis
Shar pei, English foxhound, Beagle
List 3 breeds of cats that have congenital/familial renal disease
Persian - polycystic kidney disease
Abysinnian - amyloidosis
Siamese - amyloidosis
What variables are associated with decompensation or mortality for cats with CKD?
Plasma creatinine concentration Urine protein-to-creatinine ratio Urine albumin-to-creatinine ratio Leukocytosis Hyperphosphatemia
What variable in canine CKD has been found to be negatively associated with mortality?
Body condition score
Approximately what percentage of cats with CKD will have normal sized kidneys? small kidneys? large kidneys?
Normal 40%
Small 33%
Large 27%
WHat is the hallmark renal palpation of AKI?
large, painful kidneys
T/F- the urine pH of dogs with AKI is usually alkalotic?
false- usually acidotic unless current UTI