Renal Biochemistry

Question 1

tests for renal function

Answer 1

urinalysis
UPC
GFR
BUN
creatinine
BUN/creatinine ratio
SDMA
electrolytes

Question 2

UPC definition

Answer 2

urine protein creatinine ratio

Question 3

GFR definition

Answer 3

glomerular filtration rate

Question 4

BUN definition

Answer 4

blood urea nitrogen

Question 5

what is GFR

Answer 5

flow rate of filtered fluid through the kidney

Question 6

why is it hard to directly measure GFR in animals

Answer 6

no standardized body surface area in animals

Question 7

what is urea

Answer 7

the principal end product of amino acid breakdown in mammals

Question 8

what is BUN

Answer 8

normally, all blood urea passes into the filtrate and approx 1/2 is reabsorbed

Question 9

why can measuring BUN give us insight into renal function

Answer 9

it can show us how well the kidneys are filtering blood

Question 10

in which types of animals is BUN less helpful

Answer 10

ruminants due to use of urea in digestive process

Question 11

causes for decreased BUN

Answer 11

starvation, over hydration, glucosuria

Question 12

causes for increased BUN

Answer 12

increased formation
decreased delivery to kidneys
impaired elimination
artifact

Question 13

what can a normal BUN indicate

Answer 13

healthy animal, subclinical renal disease, renal failure in ruminants and horses

Question 14

can a BUN within normal limits occur in an animal with kidney disease

Answer 14

yes, ruminant GI microbial utilization of BUN

Question 15

what is creatinine

Answer 15

formed from creatine
in skeletal muscle, diffuses into blood

Question 16

is creatinine a sensitive indicator of kidney function

Answer 16

no, nearly 75% os kidney tissue would need to be nonfunctional before levels rise

Question 17

can we use creatinine to evaluate renal function in birds

Answer 17

no

Question 18

causes for increased creatinine

Answer 18

severe muscle exertion/damage or dehydration

Question 19

causes for decreased creatinine

Answer 19

decreased muscle mass

Question 20

what can changes in BUN/creatinine ratio indicate

Answer 20

diet, GI hemorrhage, pre-renal azotemia

Question 21

is SDMA a sensitive marker for GFR

Answer 21

yes

Question 22

why is SDMA more sensitive than creatinine

Answer 22

increases sooner when there is kidney damage

Question 23

what are some common electrolyte alterations with renal disease

Answer 23

hyperphosphatemia
hyperkalemia/hypokalemia
hypochloremia
hypocalcemia/hypercalcemia

Question 24

hyperphosphatemia

Answer 24

increase in phosphorus

Question 25

hyperkalemia

Answer 25

increased potassium

Question 26

hypokalemia

Answer 26

decreased potassium

Question 27

hypocloremia

Answer 27

decrease in chloride

Question 28

hypocalcemia

Answer 28

decrease in calcium

Question 29

hypercalcemia

Answer 29

increase in calcium

Question 30

which electrolyte/mineral alterations are commonly seen with acute renal failure

Answer 30

hyperkalemia and hyperphosphatemia

Question 31

which electrolyte/mineral alterations are commonly seen with chronic renal failure

Answer 31

hypokalemia, hypocalcemia, hypercalcemia

Question 32

renal insufficiency definition

Answer 32

reduction in renal function without clinically detectable retention of BUN/creatinine in blood

Question 33

what percentage of nephrons are lost in renal insufficiency

Answer 33

66%

Question 34

renal failure definition

Answer 34

reduction in renal function with BUN/creatinine in blood

Question 35

what percentage of nephrons are lost in renal failure

Answer 35

over 75%

Question 36

3 categories of azotemia

Answer 36

pre-renal renal post-renal

Question 37

pre-renal azotemia causes

Answer 37

decreased cardiac output, dehydration, increased protein catabolism, high protein diets, GI bleeds

Question 38

renal azotemia causes

Answer 38

renal failure

Question 39

post-renal azotemia causes

Answer 39

urinary tract obstruction urinary tract rupture

Question 40

what other test values can help determine which type of azotemia is occurring

Answer 40

GFR and urine specific gravity

Question 41

what is uremia

Answer 41

clinical manifestations associated with renal failure

Question 42

are all animals who are azotemic also uremic

Answer 42

no

Question 43

are all animals who are uremic also azotemic

Answer 43

yes

Question 44

onset of ARF vs CRF

Answer 44

ARF - rapid (days/hours) CRF - slow (months/years)

Question 45

etiologies of ARF vs CRF

Answer 45

ARF - infection, neoplasia, toxins CRF - familial, idiopathic

Question 46

prognosis of ARF vs CRF

Answer 46

ARF - immediately life-threatening, potentially reversible CRF - progressive, irreversible

Question 47

kidney size ARF vs CRF

Answer 47

ARF - enlarged and painful CRF - shrunken and irregular

Question 48

urine volume ARF vs CRF

Answer 48

ARF - oliguric, anuric, and polyuric CRF - polyuric

Question 49

urine sediment ARF vs CRF

Answer 49

ARF - active (inflammatory, RBC, bacteria, casts) CRF - inactive (maybe casts)

Question 50

BUN/creatinine ARF vs CRF

Answer 50

ARF - increased CRF - increased

Question 51

potassium ARF vs CRF

Answer 51

ARF - normo to hyperkalemic CRF - normo to hypokalemic

Question 52

PCV ARF vs CRF

Answer 52

ARF - normal to increased CRF - decreased