KIDNEYS

Nephron
Functional unit of the kidneys
Glomerular filtration rate (GFR)
- Depends on blood coming in
- Force of filtration depends on
1. Difference in diameter of afferent and efferent capillaries (afferent is thicker than
efferent) – increase in pressure as glomerulus capillaries become narrower
2. Knotting of glomerulus – increases pressure
- Molecules up to 70kDa can pass through endothelial cells of glomerulus (podocytes)
- Glomerulonephritis - inflammation of glomerulus
- Glomerulonephropathy – no inflammation
1. These two can widen the gap between endothelial cells – proteins, mainly albumin can
escape  proteinuria
2. Triad of glomerulonephropathy
- Cholesterol increase in blood
- Proteinuria
- Hypoalbuminemia
3. Tests
- Protein in urine – proteinuria (albumin in particular) - exceeds threshold of
proximal tubule
- Urea in urine/urea in blood x creatinine in blood/creatinine in urine
- Fractional excretion rate (FER)

Azotemia
Used by clinical pathologists but the clinicians see a syndrome so use the term uraemia
 Increased creatinine in blood
 Look at the concentration of creatinine in kidneys and compare to ref values (unchanged is pre-
renal so dehydration)

Whole nephron theorem

Damaged area means whole nephron does work (i.e. bowmans capsule doesn’t work so nephron doesn’t)
- Remember no regeneration but the other nephrons compensate through hypertrophy – become
larger
Can start snowball effect

Phosphorus can accumulate in longer standing conditions which also means calcium and eventually EPO
Acidosis can persist from losing other elements

Acute renal failure


Chronic renal failure
 Progressive
 Dilute urine
 Polydipsia
 Increased creatinine

Primary renal function tests

Urea and creatinine in blood
Urine specific gravity (measure of diluteness of urine)

Ideally urine SG must be over SG 24 hours

Results not standardised in dogs and cats but can be used
PCV, phosphorus, fractional excretion of the variety of components
Pre renal – increase in everything
Post renal – increase urea and no marked creatinine increase, increased potassium