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Clinical Syndromes: Azotemia and Uremia - Coggle Diagram
Clinical Syndromes: Azotemia and Uremia
CS
consistent
for kidney disease
exam
physical
check organ systems
bladder
large,
painful
urethra
prostate
kidneys
abnormal size
painful
pale mucous membranes
oral ulcers
dehydration
hypertension
hypertensive retinopathy/sudden blindness
urine
urinalysis
urine volume
frequency of voiding
water consumption
medical
vomting
weight loss
halitosis
anorexia
diarrhea/melena/hematochezia
ascites/sq edema
Pu?PD
oliguria/anuria
uremia
progressive weakness
easy fatigue
loss of appetite
nausea and vomiting
muscle atrophy
tremors
abnormal mental function
frequent shallow respiration
metabolic acidosis
uremia
CS
vomiting
halitosis
decreasd appetite/anorexia
lethargy/weakness
oral ulcers/stomatitis
halitosis
hypothermia
cannot be uremic withput being azotemia
polsystemic CS consequent to loss of kidney fxn
when?
CS usually seen when BUN exxceeds 60-80 mg/dl
BUN trends better with CS than creatinine
BUN and creatinine values may diverge
azotemia
laboratory finding
serum creatinine
BUN (serum urea)
characterized by abnormally high levels of nitrogen-containing compounds
can be azotemic without being uremic
prerenal
problem in systemic circulation that decreases flow to the kidneys
elevated serum and creatinine
reduced pressure and/or perfusion of glomerular capillaries
hypoperfusion leads to RAAS activation
angiotensin II causes vasoconstriction, reducing GFR
USG helps ID
increased Na and H2O reabsorption = increased USG
:cat: >1.035
:dog: > 1.030
conditions causing prerenal azo w/o kidney disease
hypoperfusion
dehydration
cardiac dysfunction
hypotension
impaired renal blood flow
shock
Addison's
narrowing of renal arteries
GI bleeding
concentrated urine + azotemia
aka "fluid responsive azotemia"
renal
damaged by disease or injury
decreased GFR
confirmation
inadequately concentrated urine
USG 1.007-1.029 :dog:
USG 1.007-1.034 :cat:
doesn't improve after fluid challenge
no evidence of obstruction
post-renal
obstructions in collecting system
pressure from obstruction reduces overall GFR
USG doesn't help with ID
only confirming obstruction helps
can have more than 1 type of azotemia