Reviewing the chemistry panel: Kidney cases (Proceedings)


Reviewing the chemistry panel: Kidney cases (Proceedings)

Aug 01, 2010

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


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

Hot topics on dvm360

Can you save this client? (Yes.)

VETTED - Sep 19, 2016