Renal Function (Clin Path)

Front 1

What specific gravity is seen with isosthenuria?

Back 1

USG of 1.007 - 1.013

Front 2

What specific gravity is seen with hyposthenuria?

Back 2

dilure urine
less than 1.007

Front 3

What is oligurua?

Back 3

decrease in urine production

Front 4

What is Anuria?

Back 4

no urine prodution

Front 5

What is pollakiuria?

Back 5

increased frequency of urination

Front 6

What is azotemia?

Back 6

increase urea nitrogen +/- creatinine

Front 7

What do you suspect with uremia?

Back 7

clinical signs of renal failure

Front 8

What hormones do the kidneys produce?

Back 8

erythropoietin
renin

activates vitamin D for Ca++ and P homeostasis

Front 9

What is renal insufficiency?

Back 9

function renal tissue is inadequate to maintain health

inability to concentrate urine

+/- 66% nephrons have ceased to function

Front 10

When do we see azotemia with renal function?

Back 10

75% of nephron population is functionally impaired

large functional reserve capacity if basement membrane intact

unaffected nephrons compensate and hypertrophy in function not in size

Front 11

What is renal disease?

Back 11

retention of nitrogenous waste
-urea
-creatinine

impaired ability to dilute or conetrate urine (isothenuria)

75% of the nephrons are affected

Front 12

What do serum tests show for the diagnosis of renal disease?

Back 12

urea nitrogen concentration

serum creatinine concentration

Front 13

What do see urine tests show the concentration of for the diagnosis of renal disease?

Back 13

urinary concentration capacity
urine (protein)
Urine (creatinine)
fractional excretion of protein
fractional excretion of electrolytes

Front 14

What is polyuria?

Back 14

loss of ability to concentrate urine

see low specific gravity

Front 15

What is the differential diagnosis for polyuria?

Back 15

renal failure
extra renal
-diuresis
-medullary washout
-endocrine
-pyelonephritis/pyometra
-fanconi syndrome

Front 16

Out of the 100% of BUN that comes to the kidneys, how much is excreted and how much reabsorbed?

Back 16

60% excreted to 40% absorbed

Front 17

What are prerenal causes of increased urea nitrogen?

Back 17

increased intake of protein
increased catabolism
decreased blood flow

Front 18

What are four prerenal causes of decreased urea nitrogen?

Back 18

low protein diet
hepatic insufficiency
portosystemic shunt
decreased water reabsorption in PCT

Front 19

T/F

Urea nitrogen is a reliable indicator in GFR in ruminants

Back 19

False

urea is converted into amino acids by rumen microflora

Front 20

Is creatinine reabsorbed in the kidneys?
Is creatinine produced at a constant rate?
What is this in proportion to?

Back 20

No
Yes
Muscle mass

Front 21

What does an increase in creatinine tell you?

Back 21

there is a decrease in GFR or kidney function

a decrease in creatinine isn't clinically significant

Front 22

What are reasons to do a urine specific gravity?

Back 22

-if you suspect renal disease
-geriatric wellness exams
-history of PU/PD

always submit blood with urine

Front 23

What is needed for the kidneys to concentrate urine?

Back 23

-1/3 pf nephrons functional
-produce and be responsive to ADH
-maintain a concentration gradient

Front 24

What do the kidneys need to do to dilute urine?

Back 24

active absorption of Na and Cl from the aLOH
allow little to no water to be absorbed by the collecting duct

Front 25

What do you see with isosthenurua and azotemia?

Back 25

renal failure

Front 26

T/F

Clinically you see polyuria before azotemia.

Back 26

true

Front 27

What are the qualities of acute renal failure?

Back 27

-Reversible or irreversible
-Suddenly decreased GFR
-Azotemic
-Oliguric or anuric
-Good body condition

Front 28

What are the qualities of chronic renal failure?

Back 28

-Irreversible
-Slow decrease in GFR
-Azotemic, polyuric, hyperphos
-Poor body condition
-Anemic

Front 29

What are the three qualities of end-stage renal disease?

Back 29

-Uremia with oliguria or anuria
-Isosthenuric
-Marked azotemia

Front 30

What are causes for prerenal azotemia?

Back 30

decreased renal blood flow and decreased GFR

- hypovolemia
- decreased CO
- Shock

urine volume decreases, urine specific gravity increases

Front 31

What are causes of renal azotemia?

Back 31

inflammation
infections
amyloidosis
toxins
renal ischemia/hypoxia
hydronephrosis
neoplasia

Front 32

What do you see clinically with renal azotemia?

Back 32

renal disease with major decrease in GFR, increase in urea nitrogen and creatinine

USG > 1.007 - 1.013
increase water loss

Front 33

What is post renal azotemia caused by?

Back 33

obstruction of urinary outflow distal to the nephron
-FLUTD
-goat urolithiasis/foal bladder rupture

Front 34

What is the effect of hypercalcemia on the kidneys?

Back 34

Ca affects ADH receptors
causes mineralization
causes kidney disease

Front 35

What is the cause of prerenal proteinuria?
What are some causes of this? Does this cause hypoproteinemia?

Back 35

Small amount of protein in the blood
Myoglobinuira, hemoglobinuria
No

Front 36

Do you see hypoabluminemia with glomerular dz? Tubular dz?

Back 36

Yes
No

Front 37

What does the protein, creatinine ratio tell us?
What number indicates a glomerular proteinuria?

Back 37

Estimation of urinary protein excreted in a day
>5

Front 38

Urinary fractional excretion of electrolytes is particularly useful in diagnosing what?
What do you see an increase in and how long?

Back 38

Ethylene glycol toxicity
Sodium
3 hours after ingestion (before azotemia occurs)