Kidney Function, Diseases, and Diagnostic Methods in Veterinary Medicine

What percentage of blood goes directly to the kidneys through the renal artery?

25% of blood

what is the area called where the kidneys lie in a depression?

retroperitoneal area

What is the functional unit of the kidney?

Nephron

What does GFR stand for and why is it important?

Glomerular Filtration Rate; it measures kidney function in ml/min.

What are the main functions of the kidneys?

Fluid regulation, waste product regulation, hormone regulation, electrolyte regulation, acid-base regulation, and red blood cell production.

Reacting to Aldosterone

-acts on the distal tubules

-stimulate exchange of sodium and potassium and the reabsorption

of water back into the blood

What hormone do the kidneys secrete to regulate red blood cell production?

Erythropoietin

What is the role of ADH in kidney function?

ADH (anti-diuretic hormone) helps the kidneys retain water to prevent dehydration.

Signalment of renal disease

any, In young animals, we tend to think more of toxins, cysts, and trauma

Older-we think CRF, Certain breeds of dogs and cats(Himalayans, Persians, Long hairs) prone

causes renal disease

Toxins-very long list

Cancer

Poor perfusion-heart disease, drugs, dehydration; GFR

decreases

Cysts-inherited

Parasites

Viruses, bacteria

Amyloid

Trauma-HBC

What are common clinical signs of kidney failure?

Changes in urinary habits, weakness, anorexia, uremic gastritis, depression, weight loss, and poor hair coat.

the toxins of renal disease

snake and bee venom

antifreeze

Pesticides, herbicides

heavy metals

cancer chemotherapeutic agents

aspirin and antinflammatories

anesthetics

anti parasite drugs

antibiotics

blood pressure medication

Where are ulcers found?

in the digestive system,

especially the stomach, oral, painful

how can blindness occur?

to the high blood

pressure (hypertension) that develops as a

consequence of CRF

what does blindness cause in felines?

-sodium retention

-activation of the renin-angiotensin system

-sympathetic nerve stimulation

what breeds of felines are at risk of getting CRF as they age?

Siamese ,Persian ,Abyssinian ,Burmese ,Maine

what breeds of canines are prone to CRF?

Shih Tzu ,Lhasa apso ,Basenji ,Shar Pei ,Samoyed

What is azotemia?

An abnormal concentration of urea, creatinine, and other nitrogenous substances in the blood.

SDMA (symmetric dimethylarginine- renal biomarker)

Detects kidney disease earlier than serology

Urinalysis

the examination of urine to determine the presence of abnormal elements

kidney failure=1.008-1.012

What is the significance of urine specific gravity in kidney function?

It indicates the kidneys' ability to concentrate urine; normal values are greater than 1.035 for cats and 1.025 for dogs.

BUN

byproduct of protein catabolism- cleared by kidneys

What are the causes of azotemia?

-increased rate of production (by the liver for urea; by muscles for creatinine)

-decreased rate of clearance

what are other serologic parameters to diagnosis azotemia?

blood pressure, potassium, phosphorus

goals of managing kidney disease?

nutritional mamagement, control clinical signs of uremia, Maintain adequate fluid, electrolyte and acid-base balance (P,K+,Ca++), Minimize progression of kidney disease

What is Polycystic Kidney Disease (PKD) and which breed is it commonly found in?

is an inherited condition leading to cyst formation in the kidneys, commonly found in Persian cats and other long haired cats.

What is the average age of onset for Polycystic Kidney Disease in affected cats?

congential but present Between 3 to 10 years old, with an average of 7 years.

3 parasites that invade the urinary tract and affect the kidneys?

Capillaria plica

1. dogs ingest earthworms, self-limiting infection but can cause

hematuria, dysuria

2.Capillaria feliscati

3.Dioctophyma renale (from eating raw fish and frogs)

What is the role of fluid therapy in managing kidney disease?

To maintain adequate fluid, electrolyte, and acid-base balance.

What is the relationship between hypertension and chronic renal failure?

Hypertension can develop as a consequence of chronic renal failure due to sodium retention and activation of the renin-angiotensin system.

What are the key components of nutritional management for kidney disease?

Lowering protein intake, managing cachexia, and restricting phosphorus.

What is the significance of SDMA in kidney disease diagnosis?

SDMA (symmetric dimethylarginine) detects kidney disease earlier than traditional serology.

What is the effect of alcohol on ADH?

Alcohol inhibits the secretion of ADH, leading to increased water excretion.

What are the common clinical signs of uremic gastritis?

Nausea and vomiting.

What is the impact of kidney disease on red blood cell production?

Kidney disease can lead to anemia due to decreased erythropoietin production.

What is the consequence of decreased renal excretion of potassium?

It can lead to hyperkalemia.

What is the significance of the renin-angiotensin system in kidney function?

It helps regulate blood pressure and fluid balance.

What is the typical blood pressure goal for cats with chronic renal failure?

Keep systolic blood pressure below 160 mmHg.

What is pyelonephritis?

An infection of the kidneys caused by bacteria ascending from the lower urinary tract or through hematogenous spread.

What zoonotic disease can infect dogs through contact with infected urine?

Leptospirosis, which can also affect the liver.

What are common clinical signs of pyelonephritis?

Fever, depression, lack of appetite, flank pain, polyuria/polydipsia (PU/PD), weight loss, and vomiting.

What diagnostic tests are used for pyelonephritis?

Urinalysis showing proteinuria, pyuria, bacteriuria, hematuria, and urine culture usually positive.

What is amyloidosis?

A condition characterized by the deposition of fibrous protein cells (amyloid) in the glomerulus, often hereditary in chinese shar pei dogs

diagnosis for amyloid

proteinuria

acute renal failure (ARF)

Abrupt decrease in glomerular filtration rate (GFR) due to toxins, loss of blood supply (ischemia), or urinary blockage.

ARF causes

DEHYRADTION, drugs, heart disease, lack of perfusion (main pathology leading to ARF)

What are common causes of chronic renal failure (CRF)?

Prolonged ARF, chronic immune stimulation, and diseases like persistent dental disease or inflammatory bowel disease.

What are the common causes of chronic immune stimulation?

persistent dental disease

-chronic skin infection (bacterial, fungal, viral)

-chronic allergic dermatitis

-inflammatory bowel disease, gastroenteritis, pancreatitis, hyperadrencorticism and diabetes

What is the IRIS mission?

To help veterinary practitioners better diagnose, understand, and treat renal disease in cats and dogs

one primary objective IRIS?

-establish an internationally recognized set of guidelines on the diagnosis and

assessment of progression of renal disease in small animals (IRIS Staging of

CKD)

- the board has also developed guidelines on the management of cases of CKD

(IRIS Treatment Recommendations)

CRF diagnosis

Blood panel-look for azotemia

Urinalysis-sp. Gr., casts, etc...

Radiography

Ultrasound(BX)

Excretory urogram

Laparotomy(BX)

What blood panel results indicate chronic renal failure?

Elevated BUN, creatinine, and phosphorus levels, along with decreased red blood cells indicating anemia.

What is the significance of urine specific gravity in kidney diagnostics?

Normal canine urine specific gravity is >1.025; values <1.030 in dogs or <1.035 in cats with dehydration and azotemia suggest renal insufficiency.

Isosthenuria

USG 1.008 to 1.012

Can occur in healthy dogs and cats, but renal failure should be suspected if

dehydration and/or azotemia is present

What is the treatment approach for acute renal failure?

Immediate treatment includes discontinuing suspect drugs, correcting urinary blockage, fluid therapy, and monitoring urine output.

What dietary considerations are important for chronic renal failure management?

Limited amounts of high-quality protein and phosphorus binders, along with monitoring for anemia and electrolyte imbalances.

What is the role of erythropoietin in kidney disease?

Erythropoietin stimulates bone marrow to produce red blood cells, and its deficiency can lead to anemia in kidney disease.

What are the common diagnostic methods for renal disease?

Blood panels, urinalysis, radiography, ultrasound, and biopsies.

What is the prognosis for chronic renal failure in cats?

CRF is a terminal disease with a guarded prognosis; treatment focuses on management and quality of life.

What factors can lead to renal proteinuria?

Most often caused by glomerular lesions such as glomerulonephritis and amyloidosis, altering the selective permeability of the glomerular capillaries.

What is the typical age range for cats diagnosed with chronic renal failure?

Approximately 10-30% of cats aged 10-15 years and 32% of cats over 15 years are diagnosed with CRF.

What is the treatment goal for chronic renal failure?

To manage the disease and maintain quality of life, as CRF is progressive and often terminal.

What is the significance of azotemia in renal diagnostics?

Azotemia indicates the accumulation of waste products in the bloodstream due to impaired kidney function.

What are the common causes of acute renal failure?

Dehydration, heart disease, and certain drugs that constrict renal arteries leading to lack of perfusion.

What is the impact of chronic immune stimulation on kidney health?

It can lead to the accumulation of immune complexes in the kidneys, causing damage and diminished function.

What is the expected urine output in acute renal failure treatment?

Monitoring urine output is crucial to assess kidney function and response to treatment.

What is the role of supportive care in managing amyloidosis?

There is no specific treatment for amyloidosis; management focuses on supportive care for affected animals.

chronic renal failure treatment

long term, sometimes labor-intensive, medical care, may involve dietary restrictions