Renal Failure
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Questions and Answers

Which of the following can be a cause of acute kidney injury (AKI)?

  • Inflammation/immune mediated disease
  • Poor renal perfusion (correct)
  • Protein losing nephropathy
  • Familial renal disease
  • What is a possible cause of chronic kidney disease (CKD)?

  • Nephrotoxins
  • Hypercalcaemia
  • Infection
  • Ischaemia (correct)
  • Which of the following can lead to hyperkalaemia in AKI?

  • Polyuria
  • Hypoadrenocorticism
  • Increased renal perfusion
  • Decreased renal output (correct)
  • What is a possible consequence of CKD?

    <p>Increased urea levels</p> Signup and view all the answers

    Which of the following is an early sign of renal failure?

    <p>Polyuria</p> Signup and view all the answers

    What percentage of functional loss of nephrons indicates renal failure?

    <blockquote> <p>66%</p> </blockquote> Signup and view all the answers

    What is the most common cause of end stage renal failure?

    <p>Tubulointerstitial nephritis</p> Signup and view all the answers

    Which statement about chronic kidney disease (CKD) is true?

    <p>Cats usually survive longer than dogs with CKD</p> Signup and view all the answers

    What is the rate of progression of renal failure?

    <p>Very variable</p> Signup and view all the answers

    What is the end result of renal failure?

    <p>Fibrosis</p> Signup and view all the answers

    What is acute kidney injury (AKI)?

    <p>Sudden onset damage with reversible effects</p> Signup and view all the answers

    What is the priority when managing critical care and emergency patients with renal failure?

    <p>Prevention of AKI</p> Signup and view all the answers

    When should one worry about increasing creatinine levels in a sick patient?

    <p>Always</p> Signup and view all the answers

    What is an early sign of renal failure?

    <p>Polyuria</p> Signup and view all the answers

    Which imaging modality is used to assess the location of a urine leak from the ureter?

    <p>Ultrasound</p> Signup and view all the answers

    What is the most common cause of intraluminal urethral obstruction in cats?

    <p>Calculi</p> Signup and view all the answers

    What can cause intramural urethral obstruction?

    <p>Stricture</p> Signup and view all the answers

    What is a potential post operative cause of extramural urethral obstruction?

    <p>Post-op complication with ligated ureter</p> Signup and view all the answers

    What happens when there is a complete ureteral obstruction?

    <p>Fibrosis</p> Signup and view all the answers

    What is the significance of compensatory hypertrophy of the normal kidney?

    <p>It is a reversible condition</p> Signup and view all the answers

    What are the signs of a 2nd ureteral obstruction in cats?

    <p>Both renal pain and azotemia</p> Signup and view all the answers

    What is the significance of a 2nd ureteral obstruction in cats?

    <p>It requires prompt diagnosis and treatment</p> Signup and view all the answers

    What is the most common cause of intraluminal urethral obstruction in cats?

    <p>Calculi</p> Signup and view all the answers

    What is the significance of a 2nd ureteral obstruction in cats?

    <p>It requires prompt diagnosis and treatment</p> Signup and view all the answers

    What is the definition of renal failure?

    <p>Renal failure is defined as loss of urine concentrating ability.</p> Signup and view all the answers

    What is an early sign of renal failure?

    <p>Polyuria is an early sign of renal failure.</p> Signup and view all the answers

    What percentage of functional loss of nephrons indicates renal failure?

    <p>More than 66% functional loss of nephrons indicates renal failure.</p> Signup and view all the answers

    What is the rate of progression of renal failure?

    <p>The rate of progression of renal failure is variable.</p> Signup and view all the answers

    What is the most common cause of chronic kidney disease (CKD)?

    <p>The most common cause of CKD is tubulointerstitial nephritis.</p> Signup and view all the answers

    What is acute kidney injury (AKI)?

    <p>AKI is sudden onset damage to the kidneys that may be reversible or progressive.</p> Signup and view all the answers

    When should one worry about increasing creatinine levels in a sick patient?

    <p>One should worry about increasing creatinine levels in a sick patient, even if it is not abnormal.</p> Signup and view all the answers

    What is the significance of a second ureteral obstruction in cats?

    <p>A second ureteral obstruction in cats is significant and can cause complications.</p> Signup and view all the answers

    What is the priority when managing critical care and emergency patients with renal failure?

    <p>Prevention of acute kidney injury (AKI) is a priority when managing critical care and emergency patients with renal failure.</p> Signup and view all the answers

    What is the end result of renal failure?

    <p>The end result of renal failure is fibrosis, where scar tissue replaces functional nephrons.</p> Signup and view all the answers

    What are the two possible locations of fluid accumulation as a result of urine leak from the ureter?

    <p>Retroperitoneal fluid if proximal injury, peritoneal fluid if distal injury close to bladder.</p> Signup and view all the answers

    What are the three possible causes of intraluminal urethral obstruction?

    <p>Calculi (esp calcium oxalate calculi in cats), blood clots, inflammatory debris (mucus or gunge with inflammatory cells).</p> Signup and view all the answers

    What are the two possible causes of intramural urethral obstruction?

    <p>Stricture (eg repair of damage from previous ureteric calculus that passed), neoplasia (rare).</p> Signup and view all the answers

    What is an example of extramural urethral obstruction?

    <p>Post-operative complication with ligated ureter.</p> Signup and view all the answers

    What are the consequences of a complete ureteral obstruction?

    <p>Hydronephrosis, fibrosis (&quot;small kidney&quot;).</p> Signup and view all the answers

    What can occur in the unaffected kidney when there is a unilateral ureteral obstruction?

    <p>Compensatory hypertrophy (&quot;big kidney&quot;).</p> Signup and view all the answers

    What is the significance of a second ureteral obstruction in cats?

    <p>Serious and life-threatening because often relying on the big kidney only for adequate renal function (small kidney likely non-functional or severely decreased function).</p> Signup and view all the answers

    What are the signs of a second ureteral obstruction in cats?

    <p>Renal pain and signs of azotaemia (acute kidney injury).</p> Signup and view all the answers

    What is the priority when managing critical care and emergency patients with renal failure?

    <p>Prompt diagnosis and treatment.</p> Signup and view all the answers

    What is acute kidney injury (AKI)?

    <p>Reversible renal dysfunction resulting in the rapid reduction of kidney function, typically accompanied by azotaemia.</p> Signup and view all the answers

    What are some possible causes of acute kidney injury (AKI)?

    <p>Poor renal perfusion, cardiovascular disease, severe hypoxia, nephrotoxins such as ethylene glycol, lily toxicity, grape/raisin toxicity, vitamin D supplements/human psoriasis creams, and NSAIDs at high doses especially in dehydrated patients.</p> Signup and view all the answers

    What are some possible causes of chronic kidney disease (CKD)?

    <p>Obstructive disease, infection, hypercalcaemia, cutaneous and renal glomerular vasculopathy, familial renal disease, inflammation/immune mediated disease, ischaemia/renal infarcts/vascular injury, and unknown causes.</p> Signup and view all the answers

    What are some examples of nephrotoxins?

    <p>Ethylene glycol, lily toxicity, grape/raisin toxicity, vitamin D supplements/human psoriasis creams, and NSAIDs at high doses especially in dehydrated patients.</p> Signup and view all the answers

    What are some possible causes of obstructive disease in AKI?

    <p>Calculi, blood clots, and neoplastic lesions obstructing ureteric lumen. Urethral obstruction affects both kidneys, while ureteric obstruction affects one kidney at a time.</p> Signup and view all the answers

    What are some possible causes of infection in AKI?

    <p>Localized infection in the renal pelvis (pyelonephritis), systemic infection causing damage to the kidney (leptospirosis in dogs; FIP in cats), and renal abscess (large animals, very rare in small animals).</p> Signup and view all the answers

    What is the cause of cutaneous and renal glomerular vasculopathy in dogs?

    <p>The cause is currently unknown.</p> Signup and view all the answers

    What are some possible causes of familial renal disease in dogs?

    <p>Juvenile nephropathy in Boxer dogs and renal dysplasia in Shih Tzu, Lhasa Apso, and Golden Retriever.</p> Signup and view all the answers

    What are some possible causes of familial renal disease in cats?

    <p>Amyloidosis (especially in Sharpei and Abyssinian) and polycystic kidney disease (breed specific, Persians and related breeds).</p> Signup and view all the answers

    What are some examples of inflammation/immune mediated diseases that can lead to CKD?

    <p>Glomerulonephritis and protein losing nephropathy.</p> Signup and view all the answers

    What is the most likely cause for most cases of CKD?

    <p>The cause is usually unknown, and the focus is on managing the consequences rather than treating the primary disease.</p> Signup and view all the answers

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