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 (C)</p> Signup and view all the answers

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

<p>Polyuria (A)</p> Signup and view all the answers

What percentage of functional loss of nephrons indicates renal failure?

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

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

<p>Tubulointerstitial nephritis (D)</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 (A)</p> Signup and view all the answers

What is the rate of progression of renal failure?

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

What is the end result of renal failure?

<p>Fibrosis (D)</p> Signup and view all the answers

What is acute kidney injury (AKI)?

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

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

<p>Always (B)</p> Signup and view all the answers

What is an early sign of renal failure?

<p>Polyuria (B)</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 (B)</p> Signup and view all the answers

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

<p>Calculi (A)</p> Signup and view all the answers

What can cause intramural urethral obstruction?

<p>Stricture (D)</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 (D)</p> Signup and view all the answers

What happens when there is a complete ureteral obstruction?

<p>Fibrosis (A)</p> Signup and view all the answers

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

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

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

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

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

<p>Calculi (B)</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 (C)</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

Flashcards

Acute Kidney Injury (AKI)

A sudden and reversible decrease in kidney function, often accompanied by azotemia. Often associated with poor blood flow to the kidneys.

Chronic Kidney Disease (CKD)

A progressive and irreversible loss of kidney function, often with a slow onset.

Azotemia

An elevated level of urea in the blood, often associated with kidney disease.

Poor Renal Perfusion

The primary function of kidneys is to filter blood and produce urine. This process requires adequate blood flow to the kidneys. Poor renal perfusion is any condition that reduces blood flow to the kidneys.

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Kidney stones

Kidney stones, also known as renal calculi, can obstruct the flow of urine through the ureters

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Blood clots

A blood clot can form in the urinary tract and block the flow of urine.

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Neoplastic lesion

An abnormal growth of tissue in the urinary tract can obstruct the flow of urine

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Pyelonephritis

Infection in the kidneys

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Systemic infection

A systemic infection, such as leptospirosis in dogs, can cause damage to the kidneys

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Renal abscess

A localized collection of pus in the kidney, often caused by bacteria

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Cutaneous and renal glomerular vasculopathy

A type of kidney disease characterized by inflammation of the tiny blood vessels in the kidneys

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Familial renal disease

A condition that affects the kidneys as a result of inherited genetic factors

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Inflammation/immune mediated disease

Inflammation or immune-mediated damage in the kidneys

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Ischaemia/renal infarcts/vascular injury

Damage to blood vessels in the kidneys, leading to reduced blood flow

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Post-opertive ligation of ureter

An example of extramural urethral obstruction

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Renal failure

A condition where the kidneys are unable to concentrate urine properly

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Polyuria

A condition where the kidneys are unable to concentrate urine properly, resulting in the production of large amounts of dilute urine

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Significant loss of nephrons

A significant loss of functional kidney tissue, often leading to irreversible kidney damage

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Rate of progression of renal failure

The rate at which kidney function deteriorates can vary depending on the underlying cause and other factors

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Fibrosis

Scar tissue that replaces functional kidney tissue, leading to irreversible kidney damage

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Renal dysfunction

A condition where the kidneys are unable to filter and remove waste effectively from the body

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Azotemia

The presence of increased levels of nitrogenous wastes in the bloodstream, particularly urea and creatinine

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Edema

An abnormal accumulation of fluid in the body due to the kidneys' inability to remove excess fluid

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Electrolyte imbalance

A condition where the kidneys are unable to maintain normal levels of electrolytes, such as potassium and sodium

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Hypertension

The kidneys play a crucial role in regulating blood pressure. Renal failure can disrupt this process, leading to hypertension.

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Anemia

Kidney failure can lead to anemia, a condition where the body doesn't produce enough red blood cells

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Bone disease

Kidney failure can lead to bone disease, as it affects the kidneys' ability to regulate calcium and phosphorus

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Neurologic symptoms

Kidney failure can lead to a buildup of toxins in the bloodstream, which can affect the nervous system and lead to neurologic symptoms

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Uremia

A serious condition that can occur in renal failure. It is a life-threatening condition where the body can't get rid of waste products.

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Dialysis

A procedure to remove waste products from the blood when the kidneys are unable to function properly

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Kidney transplant

A surgical procedure to transplant a healthy kidney from a donor into a patient with kidney failure

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