54 Questions
Which of the following can be a cause of acute kidney injury (AKI)?
Poor renal perfusion
What is a possible cause of chronic kidney disease (CKD)?
Ischaemia
Which of the following can lead to hyperkalaemia in AKI?
Decreased renal output
What is a possible consequence of CKD?
Increased urea levels
Which of the following is an early sign of renal failure?
Polyuria
What percentage of functional loss of nephrons indicates renal failure?
66%
What is the most common cause of end stage renal failure?
Tubulointerstitial nephritis
Which statement about chronic kidney disease (CKD) is true?
Cats usually survive longer than dogs with CKD
What is the rate of progression of renal failure?
Very variable
What is the end result of renal failure?
Fibrosis
What is acute kidney injury (AKI)?
Sudden onset damage with reversible effects
What is the priority when managing critical care and emergency patients with renal failure?
Prevention of AKI
When should one worry about increasing creatinine levels in a sick patient?
Always
What is an early sign of renal failure?
Polyuria
Which imaging modality is used to assess the location of a urine leak from the ureter?
Ultrasound
What is the most common cause of intraluminal urethral obstruction in cats?
Calculi
What can cause intramural urethral obstruction?
Stricture
What is a potential post operative cause of extramural urethral obstruction?
Post-op complication with ligated ureter
What happens when there is a complete ureteral obstruction?
Fibrosis
What is the significance of compensatory hypertrophy of the normal kidney?
It is a reversible condition
What are the signs of a 2nd ureteral obstruction in cats?
Both renal pain and azotemia
What is the significance of a 2nd ureteral obstruction in cats?
It requires prompt diagnosis and treatment
What is the most common cause of intraluminal urethral obstruction in cats?
Calculi
What is the significance of a 2nd ureteral obstruction in cats?
It requires prompt diagnosis and treatment
What is the definition of renal failure?
Renal failure is defined as loss of urine concentrating ability.
What is an early sign of renal failure?
Polyuria is an early sign of renal failure.
What percentage of functional loss of nephrons indicates renal failure?
More than 66% functional loss of nephrons indicates renal failure.
What is the rate of progression of renal failure?
The rate of progression of renal failure is variable.
What is the most common cause of chronic kidney disease (CKD)?
The most common cause of CKD is tubulointerstitial nephritis.
What is acute kidney injury (AKI)?
AKI is sudden onset damage to the kidneys that may be reversible or progressive.
When should one worry about increasing creatinine levels in a sick patient?
One should worry about increasing creatinine levels in a sick patient, even if it is not abnormal.
What is the significance of a second ureteral obstruction in cats?
A second ureteral obstruction in cats is significant and can cause complications.
What is the priority when managing critical care and emergency patients with renal failure?
Prevention of acute kidney injury (AKI) is a priority when managing critical care and emergency patients with renal failure.
What is the end result of renal failure?
The end result of renal failure is fibrosis, where scar tissue replaces functional nephrons.
What are the two possible locations of fluid accumulation as a result of urine leak from the ureter?
Retroperitoneal fluid if proximal injury, peritoneal fluid if distal injury close to bladder.
What are the three possible causes of intraluminal urethral obstruction?
Calculi (esp calcium oxalate calculi in cats), blood clots, inflammatory debris (mucus or gunge with inflammatory cells).
What are the two possible causes of intramural urethral obstruction?
Stricture (eg repair of damage from previous ureteric calculus that passed), neoplasia (rare).
What is an example of extramural urethral obstruction?
Post-operative complication with ligated ureter.
What are the consequences of a complete ureteral obstruction?
Hydronephrosis, fibrosis ("small kidney").
What can occur in the unaffected kidney when there is a unilateral ureteral obstruction?
Compensatory hypertrophy ("big kidney").
What is the significance of a second ureteral obstruction in cats?
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).
What are the signs of a second ureteral obstruction in cats?
Renal pain and signs of azotaemia (acute kidney injury).
What is the priority when managing critical care and emergency patients with renal failure?
Prompt diagnosis and treatment.
What is acute kidney injury (AKI)?
Reversible renal dysfunction resulting in the rapid reduction of kidney function, typically accompanied by azotaemia.
What are some possible causes of acute kidney injury (AKI)?
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.
What are some possible causes of chronic kidney disease (CKD)?
Obstructive disease, infection, hypercalcaemia, cutaneous and renal glomerular vasculopathy, familial renal disease, inflammation/immune mediated disease, ischaemia/renal infarcts/vascular injury, and unknown causes.
What are some examples of nephrotoxins?
Ethylene glycol, lily toxicity, grape/raisin toxicity, vitamin D supplements/human psoriasis creams, and NSAIDs at high doses especially in dehydrated patients.
What are some possible causes of obstructive disease in AKI?
Calculi, blood clots, and neoplastic lesions obstructing ureteric lumen. Urethral obstruction affects both kidneys, while ureteric obstruction affects one kidney at a time.
What are some possible causes of infection in AKI?
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).
What is the cause of cutaneous and renal glomerular vasculopathy in dogs?
The cause is currently unknown.
What are some possible causes of familial renal disease in dogs?
Juvenile nephropathy in Boxer dogs and renal dysplasia in Shih Tzu, Lhasa Apso, and Golden Retriever.
What are some possible causes of familial renal disease in cats?
Amyloidosis (especially in Sharpei and Abyssinian) and polycystic kidney disease (breed specific, Persians and related breeds).
What are some examples of inflammation/immune mediated diseases that can lead to CKD?
Glomerulonephritis and protein losing nephropathy.
What is the most likely cause for most cases of CKD?
The cause is usually unknown, and the focus is on managing the consequences rather than treating the primary disease.
Test your knowledge on renal failure and its defining characteristics. Learn about the signs and stages of this condition, including its prevalence in older animals.
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