Renal Components of the Chemistry Panel
1. Creatinine
2. BUN
3. Electrolytes
• Sodium: N to ↓
• Chloride: N to ↓
• Potassium: ↑
• Calcium: acute= ↓ Ca: chronic=↑
• Phosphorus: acute= ↑
• Acid – base parameters: TCO2: ↓
• Anion Gap:↑
Creatinine/BUN: Increase means that GFR has decreased (prerenal,renal) or post-renal disease is present
Renal Disease
• Hyponatremia, hypochloremia
• Hyperkalemia (normal to high)
• Metabolic acidemia (Low TCO2)
o Anion Gap often increases
• Acute Renal Failure
o Hypocalcemia
o Hyperphosphatemia
• Chronic Renal Failure
o Hypercalcemia
o Hypophosphatemia
Causes of acute renal failure: 1. Hemodynamic causes; 2. Toxic causes; 3. Inflammatory causes
1 Hemodynamic causes
• Prolonged hypovolemia
• Coagulopathy Endotoxemia/SIRS
2 Toxic causes
• Phenylbutazone
• Aminoglycosides
• Tetracycline*
• Pigments- hgb, mgb
• Heavy metals
• Blister Beetle
3 Inflammatory causes
• Pyelonephritis
• Leptospirosis
• Neoplasia
• Immune-mediated causes
Glomerulonephritis – Proteinuria
Secondary to Strep equi equi
Prerenal vs Renal Azotemia
• Horses with prerenal azotemia are dehydrated
o Urine is concentrated
o USG > 1.020
• Horses with renal azotemia are isosthenuric regardless of hydration status
o USG: 1.008 – 1.020
Prerenal
A rapid decrease in creatinine is expected with fluid therapy. It should be markedly decreased and close to normal within
24 h if prerenal. Persistent elevation of creatinine in the face of fluids indicates renal disease
Prolonged prerenal azotemia will lead to renal failure if not corrected
