Chronic_renal_failure

What is chronic kidney disease (CKD)?

A chronic, irreversible progressive disease of the kidneys lasting more than 3 months.

What percentage of nephrons can be lost before clinical signs appear in CKD?

Approximately 70% of nephrons.

What are the two broad categories of causes for chronic kidney disease?

Primary Glomerular Disease and Primary Tubulointerstitial Disease.

What is glomerular nephritis?

An inflammation of the kidney's glomeruli, potentially caused by immune complex deposition.

What can acute kidney injury (AKI) lead to without proper intervention?

Maladaptive repair and progressive scarring, potentially resulting in chronic kidney disease.

List three common clinical signs of chronic kidney disease in horses.

Weight loss, polyuria/polydipsia (PU/PD), and ventral oedema.

What does an increased creatinine level indicate?

It indicates reduced kidney function, often assessed alongside other laboratory findings.

What is the typical urine specific gravity (USG) in CKD cases?

Often around 1.009-1.014.

What does a low urine protein:urine creatinine ratio indicate?

It helps diagnose proteinuria, which may be present in CKD.

What are some serum electrolyte imbalances that may occur in CKD?

Hypercalcaemia, hyponatraemia, hypochloraemia, hyperkalaemia, and hypoalbuminaemia.

What is the purpose of transabdominal ultrasound in CKD?

To assess kidney structure and rule out nephroliths.

What is a significant complication rate for renal biopsy in CKD?

10-15% risk of colic or mild hemorrhage.

What dietary management strategies are recommended for horses with CKD?

Balanced protein, low salt, low carbohydrates, and adding vegetable oil.

What should be avoided in horses with CKD?

Toxic insults such as NSAIDs and certain antibiotics.

How often should creatinine levels be rechecked in CKD management?

Every 3 months.

What is an important aspect of managing CKD in horses?

Maintaining appetite and body weight.

What is the prognosis for long-term survival in horses with CKD?

The prognosis is poor.

What can progressive and irreversible disease progression lead to?

A decline in quality of life, prompting considerations for euthanasia.

What should be encouraged to promote kidney function in CKD?

Diuresis through adequate hydration.

What is the role of kidney biopsy in CKD management?

To help determine the specific cause of kidney disease.

What is the clinical significance of small increases in creatinine in CKD?

They are often not that useful for assessing disease progression.

Which pathogens can contribute to primary glomerular disease in horses?

Streptococcus spp and the equine infectious anaemia virus.

What is adaptive repair in the context of kidney injury?

The kidney's ability to recover from acute injury under ideal conditions.

What is maladaptive repair?

An improper healing response after kidney injury leading to chronic conditions.

What is the purpose of urine cytology in kidney disease diagnosis?

To identify neoplastic cells and other abnormalities.

Why is it important to control infections in CKD management?

To avoid further complications and support recovery.

What is the management recommendation for horses with glomerulonephritis?

Use steroids and antibiotics as needed, while avoiding nephrotoxic agents.

What management strategy can aid in progressive weight loss?

Monitoring body weight and dietary intake regularly.

When considering euthanasia, what quality of life aspect is crucial?

Maintaining the horse's quality of life as CKD progresses.

What should be done if progressive weight loss occurs in CKD horses?

Intervene to enhance nourishment and caloric intake.

Under what conditions is a renal biopsy conducted?

In cases of unilateral disease or when a specific diagnosis is needed.

What does a negative renal biopsy result imply?

It may suggest a non-specific or functional cause of kidney impairment.

Name a non-specific clinical sign often observed in CKD.

Poor appetite.

What is the importance of monitoring laboratory findings in CKD management?

To assess the severity and progression of the disease.

What does proteinuria indicate in horses with CKD?

It suggests nephron damage or inflammation.

What are some common laboratory findings in CKD?

Increased creatinine levels, altered electrolytes, and proteinuria.

How does chronic kidney disease differ from acute kidney injury?

CKD is a long-term, progressive condition, while AKI is a sudden onset of kidney failure.

What should be checked before performing a renal biopsy?

Blood pressure, especially in the context of CKD.

Why are dietary adjustments important in CKD management?

To minimize kidney workload and support overall health.

How can water intake be encouraged in horses with CKD?

By offering molasses water or electrolyte-enriched water.

What should be the focus of a veterinarian when managing a horse with CKD?

Identifying the cause and optimizing the horse's quality of life.

What is one potential outcome of unregulated nephrotoxin exposure in CKD?

Worsening kidney function and further damage to nephrons.

Why is urine analysis relevant in CKD diagnosis?

It can reveal signs of impairment, such as casts or abnormal cells.