Term
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Definition
= Increased water consumption (>100ml/kg/day)
-Important sign of renal disease
-Nonspecific
-Not considered part of uremic syndrome |
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Term
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Definition
Increased frequency of urinations with normal to increased volumes
>50 ml/ kg/ day |
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Term
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Definition
Urine production less than that required to excrete a daily solute load
< 25 ml/kg/day OR < 1 ml/kg/hour
On fluids < 2 ml/kg/hour
**implies severe dysfunction!!*** |
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Term
|
Definition
implies outflow obstruction
**death is coming**** |
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Term
| what are the 3 patterns of micturition? and where do they localize urinary disease to? |
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Definition
pollakiuria, dysuria, strangury
lower urinary tract |
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Term
|
Definition
| Increased frequency with decreased vol/urination |
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Term
|
Definition
| Pain or discomfort during urination |
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Term
|
Definition
|
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Term
| what does the glomerulus do and what is the USG? tonicity? |
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Definition
1. Forms ultrafiltrate (GFR)
2. Permselective
limits protein loss
Isotonic (300 mosm/l)
USG 1.010 |
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Term
| what occurs in the proximal tubule? USG? tonicity? |
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Definition
Isosmotically reabsorbs 70%
Na, Cl, H2O
-Reabsorbs K, glucose,
bicarbonate, Ca, phosphorous,
aminoacids, proteins
-Secretes H+, NH3,
organic acids & bases
Isotonic (300 mosm/l)
USG 1.010 |
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Term
| what occurs in the loop of henle? USG? tonicity? |
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Definition
Countercurrent multiplier/exchange
-Descending limb
Reabsorbs H20
-Ascending limb
Reabsorbs NaCl
Hypotonic (<300 mosm/l)
USG 1.003
Hypertonic (>300 mosm/l)
USG 1.060 |
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Term
| What occurs in the distal tubule? USG? tonicity? |
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Definition
-Reabsorbs small fraction of NaCl
-Major site of Ca/Phos regulation
Hypotonic (<300 mosm/l)
USG 1.003 |
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Term
| what occurs in the collecting tubule? USG?tonicity? |
|
Definition
Site of final modification
-Reabsorbs Na, Cl,
-Reabsorbs H2O and urea
relative to ADH
-Secretes K, H+, NH3
Hypo- to Hypertonic
USG 1.001-1.060 |
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Term
| what are the endocrine functions of the glomerulus? (3) |
|
Definition
Erythropoietin production
-Calcitriol (1,25 dihydroxy Vit D)
-Gastrin degradation |
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Term
| what 4 things do you use to estimate GFR? |
|
Definition
BUN
Creatinine
Iohexol clearance
Nuclear medicine renal scan (scintigraphy) |
|
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Term
| what is GFR? how does it relate to renal mass and function? |
|
Definition
Volume of ultrafiltrate formed/ per time/per kg
(n = 4.0 ml/min/kg)
directly related to functional renal mass
Best overall index of renal function |
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Term
|
Definition
Nonprotein nitrogenous compound formed in the liver from the metabolism of ammonia (NH3)
Filtered and reabsorbed
Indirect index of GFR
Easy to measure
Inversely proportional to GFR
Relationship NOT linear |
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Term
| ***when does BUN exceed normal reference range? |
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Definition
| does not exceed normal reference range until approximately 75% of renal functional mass has been lost (insensitive) |
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Term
|
Definition
Decreased GFR
Prerenal- physiologic
Primary Renal- 75% loss of function
Post Renal- obstruction
High protein diet
GI hemorrhage
Corticosteroids (e.g Cushing’s)
Tetracyclines |
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Term
|
Definition
Low protein diet
Liver failure
Anabolic steroids |
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Term
|
Definition
Nonprotein nitrogenous compound formed from spontaneous nonenzymatic breakdown of phosphocreatine in muscle
Filtered not reabsorbed
Indirect index of GFR
Easy to measure
Less affected by nonrenal variables
Inversely proportional to GFR
Relationship NOT linear |
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Term
| what causes a high creatinine? |
|
Definition
Decreased GFR:
Prerenal- physiologic
Primary Renal- 75% loss of function
Post Renal- obstruction
Well-muscled dogs |
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Term
| is creatinine or BUN a better measure of renal function? |
|
Definition
| creatinine since its more specific |
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Term
| when will creatinine exceed normal reference range? |
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Definition
| when 75% renal functional mass is lost (insensitive) |
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Term
|
Definition
| Abnormally increased amount of protein in urine |
|
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Term
| what does protein in the urine indicate? |
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Definition
| Persistent renal proteinuria in moderate to large quantities occurring in the absence of hematuria or pyuria indicates the presence of generalized glomerular disease |
|
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Term
| what 3 ways can you detect protein in the urine? |
|
Definition
dipstick
sulfosalicyclic acid
urine protein/creatinine ratio |
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Term
| what does the USG tell you? |
|
Definition
| Index of ability to conserve water (concentrate urine) or excrete water (dilute urine |
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Term
| to be able to concentrate urine > 1.030 in dogs and > 1.040 in cats requires at least how much functional renal mass? |
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Definition
|
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Term
| what is one of the earliest signs of renal insufficiency? |
|
Definition
| Inability to appropriately concentrate (or dilute) |
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Term
| what helps you localize kidney issues to PRERENAL |
|
Definition
Physiologic transient
e.g. fever, exercise
Overload
Low MW proteins filtered, not reabsorbed
e.g.myoglobin (17,000 MW) |
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Term
| what helps you localize kidney issues to RENAL/GLOMERULAR? |
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Definition
Congenital glomerulopathies
Glomerulonephritis
Amyloidosis
Glomerulosclerosis
Renal tubular injury |
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Term
| what helps you localize renal issues to POST RENAL? |
|
Definition
|
|
Term
| what does the dipstick primarily detect? |
|
Definition
|
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Term
| what are the downsides of the dipstick? |
|
Definition
False positives
High USG (especially cats)
High pH (alkaline) |
|
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Term
| what does the sulfosalicyclic acid test detect? |
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Definition
|
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Term
| what is the downside of sulfosalicyclic acid test? |
|
Definition
False negative (Low USG)
False Positives (High turbidity,
Contrast medium) |
|
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Term
| what does the urine protein/creatinine ratio detect? sensitivity? |
|
Definition
detects all proteins
Quantitative
Very sensitive- 5mg/dl
Interpret in light of urine sediment and kidney function |
|
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Term
| what are the downsides of urine protein/creatinine ratio? |
|
Definition
False positives (Hemorrhage,Inflammation,UTI)
UPC declines with declining GFR |
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