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Clinical Reproduction & Urology I > Clinical Approach of Renal Dz > Flashcards

Clinical Approach of Renal Dz Flashcards

(51 cards)

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1
Q

What is the functional unit of kidney

A

nephron

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2
Q

What is the function of the nephron?

A
  • regulation of volume & composition of ECF –> production of urine
  • plasma ultra-filtration
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3
Q

What is GFR

A

rate at which blood circulates thru glomerulus & rate urine is produced

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4
Q

Changes in GFR means there is

A

renal dysfxn

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5
Q

decrease in GFR means

A

kidney dz

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6
Q

what is a common marker of GFR changes?

A

Azotaemia

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7
Q

Changes of GFR means there can be what conditions?

A

AKI or cKD

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8
Q

proteinuria is a sign of

A

kidney dz, specific to glomerular damages

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9
Q

proteinuria is independent from

A

a decrease in GFR

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10
Q

PU/PD is a sign of

A

renal dz

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11
Q

Non-specific reported clinical signs of renal dz

A
  • lethargy
  • weight loss
  • anorexia/inappetence
  • V
  • uraemic crisis
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12
Q

Signs referable to systemic hypertension (more in cats than dogs)

A
  • blindness
  • hyphaemia
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13
Q

Potential nephrotoxicity can occur b/c of…

A
  • toxin exposure
  • infectious agents
  • medications
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14
Q

indicators of azotaemia

A
  • urea
  • creatinine
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15
Q

pre-renal leads to

A

decreased perfusion

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16
Q

If USG >1.030 (dogs) or >1.035 (fel) then azotaemia is

A

pre-renal or higher

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17
Q

pre-renal azotaemia is usually caused by

A

dehydration

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18
Q

renal causes of azotaemia

A

CKD or AKI

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19
Q

post-renal causes of azotaemia

A

Lower UT obstruction or rupture

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20
Q

What is the gold standard for testing for renal dz

A

GFR

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21
Q

serum creatinine concentration is a surrogate for

22
Q

Every time the GFR decreases by half, then

Study These Flashcards
A

S-creat doubles

23
Q

serum creatinine conc is influenced by

24
Q

increases in serum creatinine means there are

Study These Flashcards
A

irreversible losses in kidneys

25
S-creatinine can increase by what % after a meal?
20% - measure on fasted P
26
BUN is less ... than creatinine
specific & sensitive
27
BUN should always be interpretted w/
creatinine
28
BUN is great for
the level of toxins & consequence of renal fxn
29
Low GFR means
there is an impaired ability to excrete proteinaceous catabolites (excreted by GFR)
30
BUN acts as a surrogate for all...
uraemic toxins, correlating w/ uraemic clin signs (V, ulcers, lethargy...)
31
What is the goal of a low protein diet>
limit uraemic toxin production
32
BUN increases w/
GI ulcers/bleeding Enhanced protein catabolism Dehydration/pre-renal azotaemia Drugs
33
BUN decreases w/
PSS or other hepatic failure, low protein diet
34
SDMA has a strong correlation w/
GFR & S-creatinine
35
Hyperphosphataemia
* decline in GFR = retention of PO4 * Serum PO4 conc = directly linked to mortality in human, cats, dogs w/ CKD * Ca x PO4 product = assoc'd w/ increased mortality * Reduced intake of PO4 only way to control & limit PO4 retention
36
Metabolic acidosis
* common finding in CKD * promotes V, anorexia, lethargy, muscle wasting, weight loss * balance maintained by tubular excretion of H+ via ammonium or PO4 & reabsorption of bicarb
37
Reduced reabsorption of HCO3- not typical in
feline & canine CKD
38
Calcium
* ionised Ca can be up or down in P's w/ CKD * Hypocalcaemic in cats w/ CKD * Total Ca in cats w/ CKD hypercalcaemia
39
K
* AKI: accumulates in blood --> life-threatening --> arrhythmias, death * CKD: lost due to fibrosis/leak in UT, HypoK, supplement
40
Hypokalaemia is common in CKD of what species?
cats
41
primary hyperaldosteronism occurs in geriatric cats - it has what conditions?
severe hypokalaemia, polymyopathy, refractory hypertension
42
USG is essential to differentiate
pre-renal from primary renal dz
43
Adv'd CKD has what USG?
Isosthenuria (1.008-1.012), kidneys no longer modifying urine conc from plasma conc
44
USG < 1.006 means
not consistent w/ renal azotaemia --> urine dilution req's proper renal fxn
45
Non-regen anaemia
Lack of EPO, slow progression w/ dz progression
46
Infectious dz screening in urinary tract
UTI +/- pyelonephritis 14-15% dogs w/ azotaemia WBC Lepto Borreliosis FIP
47
AKI is potentially
reversible
48
Chronic renal dz
irreversible & progressive loss of kidney fxn (3+ mos)
49
How do you diagnose chronic renal failure?
* medical hx & PE * Hx of changes in renal values, UA (USG, Proteinuria) * structural changes seen on imaging)
50
Azotaemia is NOT synonymous w/
CKD
51
To determine cause of azotaemia, one must...
* perform an U/A * differentiate btw pre-renal, renal, post-renal

Clinical Reproduction & Urology I (29 decks)

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