Term
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Definition
existence of abnormal kidney parenchyma
regardless of extent of disease
morphologic or functional
may/maynot cause renal insufficiency
may regress, persist, or advance |
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Term
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Definition
existence of impaired kidney function because of disease
any of many specific functions can be abnormal |
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Term
|
Definition
a type and degree of renal insufficiency
kidney is not able to maintain regulatory, excretory, or endocrine functions
retention of nitrogenous solutes
derangements of fluid, electrolyte, and acid-base balance
GFR is impaired
elevated BUN, creatinine, and nitrogenous wastes |
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Term
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Definition
kidney damage that has existed for at least 3 months
decreased GFR by more than 50% from normal for at least 3 months |
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Term
| Loss of 2/3 of functional nephrons |
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Definition
| impaired ability to concentrate and dilute urine |
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Term
| Loss of 3/4 of functional nephrons |
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Definition
primary renal azotemia
retention of metabolites |
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Term
|
Definition
high concentration of non protein nitrogen substances in ECF regardless of cause
due to increased production of urea from liver and/or creatinine from muscle
decreased rate of excretion
may/maynot be caused by renal disease
may be prerenal or postrenal |
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Term
|
Definition
abnormal quantities of urine constituents in blood
due to inability to form and excrete urine adequately
polysystemic toxic syndrome that occurs from renal dysfunction
may/maynot be caused by renal disease
may be postrenal
all uremic patients have azotemia but not all azotemic animals are uremic
clinical signs are nonspecific |
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Term
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Definition
measurement of density of urine compared to pure water
estimate of osmolality
depends on both number and molecular weight of solute particles |
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Term
|
Definition
| urine with a high specific gravity and osmolality compared to glomerular filtrate |
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Term
|
Definition
urine with a specific gravity and osmolality similar to plasma and glomerular filtrate
1.008 - 1.012
loss of ability to concentrate/dilute |
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Term
|
Definition
nonprotein nitrogen substance formed by the liver as a mechanism for excreting ammonia
diffuses throughout body compartments
kidneys main route of excretion
measurement provides crude index of renal function
any abnormalitiy that decreases GFR with increase BUN
eating a lot of protein will increase BUN
will not detect elevated BUN until loss of 75% of renal mass
can still have normal BUN with significant reduction in GFR |
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Term
|
Definition
another form of nonprotein nitrogen
formed by nonenzymatic metabolism of creatine and phosphocreatine in muscle
diffuses through compartments slower than urea
kidneys are major route of excretion
crude index of GFR
affected by any abnormality that affects GFR
will not detect elevations until 75% of renal mass lost
could be in normal range and still have impairment of GFR |
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Term
| Glomerular Filtration Rate |
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Definition
can be determined/measured
endogenous/exogenous clearance methods |
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Term
|
Definition
azotemia caused by renal parenchyml disease or damage that has occured recently
potentially reversible
development of oliguria, declining GFR, increasing serum creatinine and lack of anemia in a patient known to have normal renal function before onset of illness |
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Term
| Acute Renal Failure Clinical Signs |
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Definition
development of oliguria
declining GFR
increasing serum creatinine
lack of anemia
patient known to have normal renal function before onset of illness
urine non-concentrated, sodium-rich and creatinine poor
casts in urine
lack of anemia
normal or swollen kidneys
azotemia
hyperkalemia
hyperphosphatemia/metabolic acidosis
hypocalcemia
severe uremic signs |
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Term
| Causes of Acute Renal Failure |
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Definition
Prerenal=inadequate renal perfusion
Intrinsic renal
Postrenal= urinary obstruction/leakage |
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Term
|
Definition
ethylene glycol
cholecalciferol
aminoglycosides
hypercalcemia
grapes, raisins, lily
NSAIDs
contaminated pet food |
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Term
| Initiation and Perpetuation Phase of Acute Renal Failure |
|
Definition
vascular
intratubular obstruction
tubular backleak
decrease glomerular permeability |
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Term
| Risk Factors for Acute Renal Failure |
|
Definition
poor perfusion of renal tissue
preexisting renal disease with advanced age
administration of nephrotoxic drugs |
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Term
| Clinical Presentation of Acute Renal Failure |
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Definition
acute depression, anorexia, vomiting/diarrhea
oliguria
nonoliguric forms occur
acutely uremic are depressed, hypovolemic, and hypothermic
good body condition
elevated respiration due to metabolic acidosis |
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Term
| Therapeutic Objectives in Acute Renal Failure |
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Definition
minimize further renal failure
replace fluid loss quickly (consider diuretics if not peeing)
fix hyperkalemia
acid-base imbalances
reduction of nitrogenous waste and accumulation of uremic toxins
discontinue nephrotoxic drugs
maintain adequate tissue perfusion |
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Term
| Uremic Gastropathy Physiology |
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Definition
impaired renal clearance of gastrin leads to hypergastrinemia, excessive stimulation of gastric acid secretion, and gastritis
H2 blocking agents (famotidine)
proton pump inhibitors (omeprazole)
antiemetics |
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Term
|
Definition
azotemia caused by renal parenchymal disease or damage
sufficient duration (months or more)
improvement in renal function is not possible |
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Term
|
Definition
permanent reduction in functioning nephrons
may be complicated by prerenal and postrenal components
compensatory mechanisms lead to progressive loss of function
kidney damage that has existed for at least 3 months
reduction in GFR by 50%
kidney disease can be structural or functional |
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Term
| Stage 1 Chronic Kidney Disease |
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Definition
dogs and cats are not azotemic
Cr <1.4 dogs
Cr <1.6 cats |
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Term
| Stage 2 Chronic Kidney Disease |
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Definition
mildly azotemic with PU/PD
Cr 1.4-2.0 in dog
Cr 1.6-2.8 in cat
serum creatinine may be in normal range
consider USG and hydration status
some cats have weight loss and selective appetite |
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Term
| Stage 3 Chronic Kidney Disease |
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Definition
Cr 2.1-5.0 for dogs
Cr 2.9-5.0 for cts
moderate azotemia
no signs of uremia with treatment
progressive
therapy to modify factors that cause progression |
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Term
| Stage 4 Chronic Kidney Disease |
|
Definition
severe azotemia
cr > 5.0
usually uremic clinical signs
therapy to ameliorate signs of uremia |
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Term
| Proteinuria with Chronic Kidney Disease |
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Definition
Urine Protein Creatinine Ratio >0.5 dogs/0.4 cats
need to rule of inflammation/hemorrhage with urine culture and imaging
document persistence over 1-2 months
progression correlates with amount of proteinuria |
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Term
| Proteinuria with Chronic Kidney Disease |
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Definition
Urine Protein Creatinine Ratio >0.5 dogs/0.4 cats
need to rule of inflammation/hemorrhage with urine culture and imaging
document persistence over 1-2 months
progression correlates with amount of proteinuria |
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Term
| Hypertension with Chronic Kidney Disease |
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Definition
risk of end organ injury to eyes, CNS, kidneys, heart
stage 0 has low risk hypertension
stages 1-3 reflect low, moderate, high risk |
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Term
| Causes of Chronic Kidney Disease |
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Definition
cause usually not identified
new nephrons cannot be formed after 4 weeks of age
response to injury is limited
congenital
lepto, bacterial, hypercalcemia, obstruction |
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Term
| Factors involved in progression with Chronic Kidney Disease |
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Definition
intraglomerular hypertension
glomerular hypertrophy
systemic hypertension
proteinuria
hyperlipidemia
uremic toxins
intrarenal precipitation of calcium phosphate |
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Term
|
Definition
| proteinuria and arterial hypertension are bad prognostic indicators |
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Term
| Clinical Presentation of Chronic Kidney Disease |
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Definition
nonspecific and nonlocalizing
don't recognize it until uremia develops usually in a crisis situation |
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Term
|
Definition
abrupt deterioration in animal's status
very severe azotemia and uremic signs
precipitated by changes in extrarenal factors (switching diet, water deprivation, vomiting)
decompensation of progression of CRF
obstrucitve uropathy/ARF
prerenal azotemia
vicious circle of worsening prerenal adversities and needs aggressive treatment |
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Term
| Chronic Kidney Failure Signs |
|
Definition
PU/PD
anorexia/weight loss
catabolic effects of uremia and inadequate calorie intake
low grade malabsorption secondary to uremic gastroenteritis
vomiting due to uremic toxins on chemoreceptor trigger zone
uremic gastropathy due to increase gastrin
uremic stomatitis
uremic enterocolitis
constipation in cats
arterial hypertension which damages eyes, kidneys, heart, brain
listless
poor growth
fetid breath
pallor
nocturia
lingural/oral ulceration |
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Term
| Ocular Consequences of Chronic Kidney Disease |
|
Definition
one of most easily detected
retinal arterial tortuosity
retinal hemorrhage
retinal detachment |
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Term
| Hemorrhagic Consequences of Chronic Kidney Disease |
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Definition
GI hemorrhage (hematemesis, melena)
may be a significant source of blood loss contributing to anemia
decreased platelet function
abnormalities in interaction of platelet with vessel wall |
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Term
| Lab Findings in Chronic Kidney Disease |
|
Definition
azotemia
hyperphosphatemia
metabolic acidosis
hypercalcemia/hypocalcemia/hypomagnesemia
hypokalemia
nonregenerative anemia
proteinuria
small kidneys
osteodystrophy |
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