Kidney - Ex 3 Flashcards
Define azotemia
Inc BUN and Creatinine
What % reduction in renal function results in azotemia
75%
What % reduction in renal fan results in loss of concentrating ability?
66% of nephrons have been lost
What 3 basic causes of azotemia should be considered?
Pre-renal
Renal
Post-renal
Two basic causes of pre-renal increases of BUN
Hemorrhage and infection
You can rule these out with a normal sediment
What is the most likely (and probably only) cause of a pre renal increase in creatinine?
Decreased GFR
How can USG help differentiate b/w pre-renal and renal azotemia?
Pre-renal –> normal SG
Renal –> dilute SG
Is primary renal failure the only dz in which impaired renal concentration ability is seen?
NO!
Diabetes, hyper/hypoadrenocorticism, hyperthyroidism, hypercalcemia, hypokalemia, psychogenic polydipsia, hepatic failure, pyometra…
USG in isosthenuric range - azotemic animal
Suggests renal dz
USG in isosthenuric range - random urine sample
Obtaining one urine sample with a SG in the isosthenuric range does not mean that the animal is incapable of concentration or dilution
Describe 3 basic types of proteinuria
- Preglomerular: usually mild –> abnormalities outside urogenital tract
- Glomerular: Very high!
3, Postglomerular: mild
Two types of pre-glomerular proteinuria
- Functional or physiologic –> transient glomerular alteration which allows leakage of albumin
- Overload –> excess passage of protein through glomeruli or extremely high serum concentration of protein
Comparing glomerular and tubular proteinemia, in which would you expect the highest UPC?
Glomerular (>5.0)
What is the most reliable way of differentiating glomerular proteinuria from proteinuria caused by hemorrhage and/or inflammation?
Sediment
Normal sediment –> suggests glomerular proteinuria
UPC should always be interpreted in light of…
- Urine SG
2. Sediment findings
