Term
| Three major functions that control renal excretion of H20 and solutes |
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Definition
Glomerular Filtration - Passive
Tubular Resorption - (passive or active)
Tubular Secretion - (passive or Active) |
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Term
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Definition
Water
Glucose
AA
Proteins
Na+
CL-
HCO3 |
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Term
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Definition
Urea
Creatinine
PO4
K+
H+
NH4
Lactate |
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Term
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Definition
Determiend by SIZE and CHARGE
- Albumin is too large and too negative |
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Term
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Definition
rate at which fluid moves from plasma to filtrate
- measure clearance from plasma to determine
----Iohexol and creatinine |
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Term
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Definition
Prerenal
-Blood Volume
-Cardiac output
Renal
-# of glomeruli
-Glomerular arteriole change
Post-renal
-pressure
-Plasma colloidal oncotic pressure |
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Term
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Definition
| Ability to resorb more water than solute |
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Term
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Definition
| Abilityto resorb more solute than water |
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Term
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Definition
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Term
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Definition
get HYPEROSMOLALITY of urine
Cats can concentrate really well b/c have high medurllay hypertonicity |
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Term
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Definition
Osmolality of urine is similar to plasma
- Can be indicative of kidney failure |
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Term
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Definition
| Estimate of urine osmolality |
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Term
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Definition
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Term
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Definition
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Term
| Hyperstheuria (ADH working) - Concetrating |
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Definition
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Term
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Definition
| Renal Function that is inadequate for health |
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Term
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Definition
1.Failure to dilute/concentrate urine (USG)
2. Failure to clear wastes (Urea, Creatinine) |
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Term
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Definition
when over 50% loss in funct. renal mass lost
about 2/3 lost
lose ability to Concetrate
- see Polyuria w/o azotemia
more urine but no increase in creatinine or Urea |
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Term
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Definition
3/4 of kidney lost
fail to clear wastes
see Polyuria w/ Azotemia
More urine with increased creatinie and urea in blood |
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Term
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Definition
| NO urine and high Azotemia (cant excrete) |
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Term
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Definition
| Reflects Tubulointerstial problems |
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Term
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Definition
Abrupt - hours to days
reversible or irreversible --> decreased GFR
- Toxicants, Ischemia, Infections |
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Term
| Acute renal Failure features |
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Definition
No compensation by other nephrons (they dont have time to hypertrophy)
Volume of urine Severely DECREASED - oliguric or anuria
Urine osmolality is variable b/c it depends on what was in bladder before insult |
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Term
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Definition
Increase in non-protein nitrogenous substances
Urea or Creatinine
When see increases means that there is decreased RENAL EXCRETIOn |
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Term
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Definition
| Indicator of GLOMERULAR DZ |
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Term
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Definition
USG - Indicates Tubulointerstital dz
Azotemia - indicates Glomerular Dz |
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Term
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Definition
| Is the clinical signs associated with renal failure and is not Azotemia |
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Term
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Definition
Ammonium form intestine and tissue break down --> goes to liver and is converted to Urea
Freely Filtered at Glomeruli
Some reabsorbed - not as good of marker
Excreted in feces and Urine |
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Term
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Definition
Byproduct of Muscles --> into blood --> freely filtered at glomerulus
NOT reabsorbed so better marker of GRF |
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Term
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Definition
- Decreased Excretion
- Increased Production of UN/Crea |
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Term
| Increased Production of Urea/Creatinine |
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Definition
- Less significant cause of Azotemia
Can be from:
Increased protein in diet
Intestinal Hemorrhage
Increased protein catabolism |
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Term
| Decreased excretion of Urea/Crea |
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Definition
Most common cause of Azotemia
prerenal, Renal, Postrenal |
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Term
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Definition
| - Decreased renal plasma flow |
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Term
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Definition
| Loss of nephrons or vasculture in kidneys |
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Term
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Definition
- Rupture- Urine leaking out and getting resorbed into blood
- Obstruction |
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Term
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Definition
- Decreased Plasma Flow to Kidney
Hypovolemia
Decreased Cardiac Output
Shock |
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Term
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Definition
Anything that damages the function of the kidney
Inflammatory
Amyloidosis
Toxicity
Ischemia
Congenital hypo/aplasia
Neoplasia
hydronephrosis |
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Term
| Post renal Azotemia Causes |
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Definition
Obstruction - Uroliths or neoplasia
Leakage of urine into body (trauma) |
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Term
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Definition
USG greater than
>1.030 - dog
>1.040 - cat
>1.025 - LA
there would be a decrease in GFR -->
assumes NO extrarenal factis affecting the renal concetrating ability |
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Term
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Definition
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Term
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Definition
USG depends on the bladder
NEED CLINICAL SIGNS TO DETERMINE |
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Term
| If Pre-renal azotemia is from Increased Urea/Crea production |
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Definition
USG is variable and
Azotemia is MILD |
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Term
| Renal Azotemia from EXTRARENAL DISEASE |
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Definition
- Distal Nephron is unresponsive to ADH (cant reabsorb water)
- Solute Overload (osmtic Diuresis
- Decreased medullary hypertonicity (Prolonged hyopnatremia, loop diuretics, Decreased UREA (liver dz) solute overload, prolonged diuresis) __> All cause inability of kidneys to concentrate |
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Term
| Disorders that cause Decreased Urea synth |
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Definition
Liver Disease (hepatocellular dz, portosystemic shunt)
Urea Cycle enzyme problem
This is a problem b/c 50% of the kidneys interstital tonicity comes from UREA --> will have decreased concentrating ability |
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Term
| Problem with decreased Urea |
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Definition
Liver Failure --> Decreased Urea --> Decreased Tonicity of kidney --> inability to concentrate urine
50% of the kidneys interstital tonicity comes from UREA --> will have decreased concentrating ability |
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Term
| Disorders that cause dec. urea excretion |
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Definition
disorders that impair prox tubular reabsorption or urea --> Glucosuria
Central or nephrogenic diabetes insipidus |
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Term
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Definition
usually from kidney failure not being able to clear
Muscle damage + renal failure can do it too (tied-up horses |
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Term
| Creatine is affected by less factors than Urea (and urea is reabsorbed) |
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Definition
1. Urea resporption INCREASES with hypovolemia b/c decreased flow rate (sits in tubules longer)
2. Increased GI Protein --> Increased urea synthesis |
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Term
| If the Urea: Creatinine ratio is Increased (more urea) |
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Definition
Most likely a PRE-RENAL azotemia
-- Azotemia reflects a glomerular problem (NOT tubular) |
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Term
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Definition
Do within 1 hr of collection
- things deteriate
Bacteria grow
Crystals form or dissolve |
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Term
| Urinalysis - Composition of Urine depends on |
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Definition
1. Plasma volume and content presented to kidneys
2. renal Functions (filtration, resorb, secret)
3. Material added w/in urinary tract |
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Term
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Definition
| Color does not correlate to Concentration |
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Term
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Definition
Causes
Hematuria - RBC
hemoglobinuria - Hemoblobin
myoglobinuria- Muscle
Orange tinge from Billirubin |
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Term
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Definition
Cells
Crystals
Casts
NOT PROTEIN - not a suspended particle |
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Term
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Definition
Depends on water intake
Use USG to estimate solute concentration |
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Term
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Definition
Usually a good estimate of osmolality
Can be flasely INCREASED with high protein or Glucose |
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Term
| Inappropriate USG's for dehydrated animals |
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Definition
<1.030 in Dogs
<1.040 in cats
Should be able to concentrate more than that |
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Term
| DIp stick solute [ ] reaction |
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Definition
USG determines the significance of [solute]
+ chemical reaction means it is present,
Then have to weigh the reaction with the USG findings |
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Term
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Definition
Very little in health
May see FALSE increase when pH is 8-9 |
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Term
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Definition
Prerenal (Overflow) -->
1. Hemoglobin,
2. Myoglobin,
3. Immunoglobin lt chain
Glomerular - Leakey filtration barrier
Tubular - When the small amount of protein that is filtered out doesnt get reabsorbed by tubules (MILD)
Hemorrhagic or inflammatory - anywhere in tract |
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Term
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Definition
Passes freely through glomerlus but is 100% resorbed by tubules in health
Renal threshold - the level that the renal tubules can no longer resorb glucose |
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Term
| Intereference of Glucose in Urine |
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Definition
Bleach -->False Increase
Cold Sample --> False Decrease |
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Term
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Definition
1. If glucose in blood is high (Glucosuria) ex. Diabetes MEllitus
2. Renal (tubular DZ) --> glucose not resorbed |
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Term
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Definition
Produced from lipid metabolism
Acetoacidic acid or acetate , not ßHB |
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Term
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Definition
Occurs with lipid metabolism
Ketones are NEGATIVELY charged do when excreted pull out Na+ and K+
Ketones are also acid so can cause Ketoacidosis |
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Term
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Definition
| anything with peroxidase activity can cause. |
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Term
| If get Heme + reaction can be |
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Definition
1. Hematuria - RBC
1. Hemoglobinuria - intravascular hemolysis (anemia, Pink plasma)
3. Myoglobinuria - from muscle damage
4. Peroxidase activity = H2O2 or bleach |
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Term
| Dehydration leading to Pre-Renal Azotemia |
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Definition
2 mechanisms
1. Dehydration --> dec plasma flow --> drc GFR
2. Dehydration --> Inc. Urea Resorption in kidney b/c sitting in tubules longer |
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Term
| When USG increases with Dehydration |
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Definition
Diarrhea --> Dec. Blood Volume --> Increase ADH--> Collecting Tubule permability --> More H20 absorption --> inc USG (more concentrated)
This is how you want it to respond |
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Term
| Chronic Renal Failure / Protein Losing Nephropathy Hallmakrs |
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Definition
Azotemia
Isosthenuria (failure to concentrate urine
Proteinuria |
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Term
| Azotemia from renal failure |
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Definition
| Decrease REnal Functional mass --> Dec GFR (b/c less glomerular --> dec clearance |
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Term
| low USG with renal failure |
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Definition
| Dec. Renal Functional mass --> inability to concentrate urine |
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Term
| 2 mechanisms of Glucosuria |
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Definition
1. Hyperglycemia
2. tubular dz not resorping all the glucose back |
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Term
| Mechanism of Azotemia caused by obstruction |
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Definition
| Obstruction --> Increased Vasoactive compounds --> afferent arteriolar constriction --> decrease GFR |
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Term
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Definition
| Glucosuria --> Osmotic Diuresis |
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Term
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Definition
1. Central Diabetes Insipidus (dec. ADH)
- Hyperadrenocorticoism - cortoson
- pituitary disorder
2. Renal Diabetes Insipitus (dec ADH response)
- evidence
---hypercalcemia, Hypoadrennocorticism, Hyperadrenocort, Pyometria, Liver failure, HypoKalemia |
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Term
| Hypostenuria mech from central diabetes insip |
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Definition
| Hypothalmus/Pituitary problem --> Dec ADH --> CT impermibility --> dec water resorbtion --> USG < 1.007 |
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Term
| Urine Protein:Creatinine Ration |
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Definition
| normally <1 b/c less protein than creatinine |
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Term
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Definition
Have a Protein Losing Nephropathy
-Effusion/Edema
-Hyperchloesterolemia
- Hypoalbuminemia |
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Term
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Definition
| ONLY only one with Hypoalbuminemia and can be marked |
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Term
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Definition
| With a glomerular proteinuria the glomerular are leaky so albumin leaks through but, urea and creatinine leak through just fine too so no increase |
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