UROLOGY 2 & 3: KIDNEY DISEASE Flashcards
(52 cards)
Kidney disease is considered chronic when it ahs been present for how long?
at least 3 months
is chronic kindey disease reversible?
what about acute kidney disease?
chronic: no
acute: yes
Describe the significance of super nephrons in CKD
remaining nephrons will try to compensate for damaged ones, leading to vicious cycle n long term damage
common causes of kidney disease?
- Drugs/Medications
- Toxins
- Infection
- Inflammation
- Hypoperfusion
- Acute kidney injury
- Metabolic events
- Thromboembolic events
What are common clinical signs of Chronic Kidney Disease?
- Polyuria and polydipsia
- Decreased appetite/anorexia
- Weight loss [due to protien loss through urine]
- Vomiting
- Muscle weakness[due to K+ loss in urine]
- Anaemia
- Constipation [due to dehydration]
high BP
What are some other possible differntial for PU/PD?
“Diabetes mellitus,” “Hypoadrenocorticism,” “Hyperadrenocorticism,” “Hypercalcaemia,”
“Pyometra,”
“Hepatic disease,”
“Hyperthyroidism,”
“Medications” (steroids, diuretics), “Diabetes insipidus,”
“Psychogenic polydipsia(some of these r a diagnosis of exclusion)
clinical signs of CKD appear after loss of funciton to what % of total kidney nephrons?
66%
How is Chronic Kidney Disease diagnosed?
- Haematology
- Serum biochemistry
- Urinalysis
- Blood pressure measurement
What are the stages of CKD according to IRIS?
- Stage 1: No clinical signs
- Stage 2: Mild clinical signs
- Stage 3: Increasing clinical signs
- Stage 4: Severe clinical signs
What are some main things to be managed in CKD?
dehydration
cachexia
diet
hyperphosphataemia
proteinuria
urinary tract infections
hypokalaemia
anaemia
high BP
What are 2 ways that CKD dehydration can be managed? [a bit obvious]
water provision [how do they like their water
fluid therapy [likely @ home by owner]
What are some aspects of CKD presciption diets?
less protien
less phophate
more calorie dense (fattY)
wet food
possibly omega 3, B vitamins, pottasium, anti-oxidants, etc
What care should be given regarding WHEN to introduce prescription diets for CKD?
do not introduce during hospital: will get ptsd and not want to eat it
What is a broad cause and treatment of hyperphosphataemia due to CKD?
casue: GFR decreases, blood phophate increases
tx: phosphate binders that stick to phosphate in food n prevent digestion of it
how can hyperphosphataemia lead to rubber jaw disease in CKD?
hyperphosphataemia.
now Ca:P ratio needs to be maintained
calcium leaching form bone and increase in PTH
can excessively leach calcium, rubber jaw
what are potential treatments of protienuria due to CKD?
how do they work?
what is a potential side effect to them?
ACE (angiotensin converting enzyme) inhibitos
dialation to efferent arterioles, reducing amount of protien that is pushed out
potential SE is systemic vasodialation
What is a proteinuria tx drug that may be used in cats?
amlodipine besylate
[calcium chanel blocker, arteriolar dialation]
Why would CKD lead to UTIs?
bc urinary sphincters are always open due to always peeing
[urine] is not high enough to kill off bacteria
What is given is severe cases of anaemia due to CKD?
What about less severe cases?
blood transfusion
ESA (erythtocyte stimulating agent)
What is Acute Kidney Injury (AKI)?
AKI is characterized by a sudden reduction in renal function that is potentially reversible
Which species has better prognosis of CKD?
cats
What are the 4 stages of Acute Kidney Injury?
Briefly describe them
- Initiation [exposure to causal agent]
- Extension [inflammation n hypoxia leading to nephron damage]
- Maintenance [irreversable nephron damage]
- Recovery [repair n regeneration of nephrons]
What are common clinical signs of Acute Kidney Injury?
- PUPD
- Anuria
- Lethargy
- Vomiting/diarrhoea
- Weakness
- Altered mentation
- Abdominal pain
What are some diagnostic techniques to look for AKD?
