Chronic Renal (Kidney) Disease | Rochester MN

Definition: inability of kidneys to perform normal functions:

1. excretion of wastes (BUN, Amylase, Creatinine, Phosphorus)

2. regulation of electrolytes (sodium, chloride, potassium)

3. synthesis of erythropoietin (stimulates red blood cell production)

4. regulation of fluids (can lead to increased drinking and urination)

Chronic kidney disease is a progressive (over months to years) disease that occurs in 9/1000 dogs and 16/1000 cats examined.

Causes: **idiopathic (no known cause) is the most common in dogs and cats, genetic, inflammation, amyloidosis (protein deposits of the kidney), cancer, others

Signs: weight loss, lethargy, anorexia, weakness, GI signs, malodorous breath (uremic), increased drinking and urinating, odd behavioral changes

Bloodwork:

1. elevated BUN, Creatinine, Phosphorus, Amylase (loss of 75% of kidney function before see dramatic elevations)

2. nonregenerative anemia (low red blood cell count associated with chronic disease)
   

Blood pressure: can be elevated (>180mmHg)

1. makes kidney disease worse

2. potential cause of blindness
   

Urinalysis: loss of ability to concentrate urine (check specific gravity of urine <1.030 in dogs and <1.035 in cats with elevated kidney values, mild protein loss)

Treatment: Since this is an irreversible disorder with often no underlying cause the goals of therapy are to increase quality of life and slow the progression of disease by:

1. maintaining fluid and electrolyte balance

   1. unlimited access to water at all times

   2. supplemental fluids given under the skin on a routine basis

   3. decreased sodium in the diet

2. nutrition

   1. decreased phosphorus

   2. decreased protein (decreases nitrogenous waste, ie BUN)

   3. decreased sodium (decreases blood pressure and helps electrolyte balance)

   4. buffering diet (alkaline to help with metabolic acidosis of kidney failure)

3. blood pressure (if elevated >180mmHg)

   1. oral medications

   2. decreased sodium in diet

4. other possible medications:

   1. phosphate binders- if the phosphorus becomes elevated this oral medication can be given to make the body eliminate the phosphorus in the stool rather than the urine

   2. erythropoietin- if the anemia falls too low this medication can be administered but there are potential significant side effects with this drug (such as seizures, increased blood pressure and the forming of antibodies to the patient’s own red blood cells making the anemia worse) and it is very expensive.

   3. There are also many medications that will need to be avoided that can put an unnecessary strain on the kidneys.