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Chronic Kidney Disease, An Issue of Veterinary Clinics of North America: Small Animal Practice, E-Book

Chronic Kidney Disease, An Issue of Veterinary Clinics of North America: Small Animal Practice, E-Book

David J. Polzin | Larry D. Cowgill

(2016)

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Book Details

Abstract

This issue of Veterinary Clinics of North America: Small Animal Practice focuses on Chronic Kidney Disease. Article topics include: New Biomarkers for Detecting Kidney Disease; Is Progressive CKD a Slow AKI?; Current Understanding of the Pathogenesis of Progressive CKD in Cats; Controversies; Update on Managing Feeding and Hydration in Dogs and Cats with CKD; Update on Phosphorous and Calcitriol Therapy; Update on Medical Management of Clinical Manifestations of CKD; and more!

Table of Contents

Section Title Page Action Price
Front Cover Cover
Chronic Kidney Disease\r i
Copyright\r ii
Contributors iii
EDITORS iii
AUTHORS iii
Contents vii
Preface\r vii
Symmetric Dimethylarginine: Improving the Diagnosis and Staging of Chronic Kidney Disease in Small Animals\r vii
Kidney Disease and the Nexus of Chronic Kidney Disease and Acute Kidney\rInjury: The Role of Novel Biomarkers as Early and Accurate Diagnostics\r vii
Is Progressive Chronic Kidney Disease a Slow Acute Kidney Injury?\r vii
Current Understanding of the Pathogenesis of Progressive Chronic Kidney Disease in Cats\r viii
Controversies in Veterinary Nephrology: Renal Diets Are Indicated for Cats\rwith International Renal Interest Society Chronic Kidney Disease Stages 2 to 4:\rThe Pro View\r viii
Controversies in Veterinary Nephrology: Renal Diets Are Indicated for Cats\rwith International Renal Interest Society Chronic Kidney Disease Stages 2 to 4:\rThe Con View\r viii
Controversies in Veterinary Nephrology: Differing Viewpoints: Role of Dietary\rProtein in the Management of Feline Chronic Kidney Disease\r ix
Utilization of Feeding Tubes in the Management of Feline Chronic Kidney Disease\r ix
Management of Proteinuria in Dogs and Cats with Chronic Kidney Disease\r ix
Update on Mineral and Bone Disorders in Chronic Kidney Disease\r ix
Does Secondary Renal Osteopathy Exist in Companion Animals?\r x
Update on Medical Management of Clinical Manifestations of Chronic Kidney Disease\r x
Nephroureteral Obstructions: The Use of Stents and Ureteral Bypass Systems for Renal Decompression\r x
Update on the Current Status of Kidney Transplantation for Chronic Kidney Disease in Animals\r x
VETERINARY CLINICS OF\rNORTH AMERICA: SMALL\rANIMAL PRACTICE\r xii
FORTHCOMING ISSUES xii
January 2017 xii
March 2017 xii
May 2017 xii
RECENT ISSUES xii
September 2016 xii
July 2016 xii
May 2016 xii
Preface xiii
Symmetric Dimethylarginine 941
Key points 941
Introduction 941
Discovery 942
Biochemistry 942
Methylarginine Synthesis 942
Elimination 943
Current challenges with assessing kidney function 943
Glomerular Filtration Rate 943
Poor Sensitivity and Specificity of Serum Creatinine Testing 944
Analytical Variability of Serum Creatinine Measurements 945
Criteria for a Better Kidney Biomarker 945
Symmetric dimethylarginine correlates with glomerular filtration rate 946
Dogs with X-linked Hereditary Nephropathy 946
Cats, Azotemic and Nonazotemic 947
Reference interval development 947
Dogs 948
Is Progressive Chronic Kidney Disease a Slow Acute Kidney Injury? 995
Key points 995
THE 2015 INTERNATIONAL RENAL INTEREST SOCIETY NAPA MEETING 996
IS THERE A NEED TO DISTINGUISH TWO SPECIFIC TYPES OF KIDNEY DISEASE: ACUTE VERSUS CHRONIC? 998
IDENTIFICATION OF PROGRESSIVE CHRONIC KIDNEY DISEASE: THE SEARCH FOR ACTIVE INJURY MARKERS 1001
CANDIDATE BIOMARKERS FOR ACTIVE KIDNEY INJURY 1002
POTENTIAL APPLICATION OF NOVEL ACTIVE INJURY KIDNEY BIOMARKERS TO FORECAST EARLY KIDNEY INJURY 1005
Early Recognition of Acute Kidney Injury 1005
Active Kidney Injury in Urinary Tract Infection 1006
Active Kidney Injury in Acute and Chronic Cardiorenal Syndrome 1008
IS PROGRESSIVE CHRONIC KIDNEY DISEASE A SLOW-MOVING ACUTE KIDNEY INJURY? A NEW LOOK AT CHRONIC KIDNEY DISEASE 1008
REFERENCES 1011
Current Understanding of the Pathogenesis of Progressive Chronic Kidney Disease in Cats 1015
Key points 1015
INTRODUCTION 1015
CAUSE OF FELINE CHRONIC KIDNEY DISEASE 1016
AGING AND THE KIDNEY 1016
ASSOCIATION OF CHRONIC KIDNEY DISEASE WITH DEMOGRAPHIC, ENVIRONMENTAL, AND INDIVIDUAL FACTORS 1018
ASSOCIATION OF THE DEVELOPMENT OF CHRONIC KIDNEY DISEASE WITH CONCURRENT DISEASE 1019
Cardiovascular and Renal Disorder 1019
Diabetes Mellitus 1020
Hyperthyroidism 1020
Upper and Lower Urinary Tract Stone Disease 1021
Infectious Disease 1021
Urinary tract infections and pyelonephritis 1021
Feline immunodeficiency virus 1021
Morbillivirus 1022
Leptospirosis 1022
Bartonellosis 1022
RENAL INFLAMMATION AND FIBROSIS: THE KIDNEY’S RESPONSE TO INJURY 1022
Myofibroblasts 1024
Inflammatory Cells 1025
Pericytes 1025
Tubular Epithelial Cells 1026
EVIDENCE OF FIBROSIS IN FELINE CHRONIC KIDNEY DISEASE 1026
MECHANISMS OF PROGRESSION AND MALADAPTIVE REPAIR IN CHRONIC KIDNEY DISEASE 1027
HEMODYNAMIC ADAPTATIONS 1027
ACTIVATION OF THE RENIN-ANGIOTENSIN-ALDOSTERONE SYSTEM 1028
SYSTEMIC HYPERTENSION 1031
PROTEINURIA 1032
HYPERPHOSPHATEMIA 1033
HYPOXIA 1034
OXIDATIVE STRESS 1035
SUMMARY 1037
REFERENCES 1038
Controversies in Veterinary Nephrology: Renal Diets Are Indicated for Cats with International Renal Interest Society Chroni ... 1049
Key points 1049
THE EFFECTS OF IMPAIRED KIDNEY FUNCTION ON FOOD AND WATER INTAKE 1049
FELINE RENAL DIETS AND NUTRITION IN CHRONIC KIDNEY DISEASE 1050
EVIDENCE SUPPORTING RENAL DIETS AS EFFECTIVE IN CATS WITH CHRONIC KIDNEY DISEASE 1051
WHAT IS THE RATIONAL FOR PROTEIN RESTRICTION IN RENAL DIETS? 1052
THE INTERNATIONAL RENAL INTEREST SOCIETY’S GUIDELINES FOR DIETARY THERAPY IN CHRONIC KIDNEY DISEASE 1055
MUSCLE WASTING AND THE UREMIC ENVIRONMENT 1056
FEEDING HIGHER-PROTEIN DIETS TO CATS WITH CHRONIC KIDNEY DISEASE 1058
RENAL DIETS: WHERE DO WE GO FROM HERE? 1059
CLINICAL DECISION PROCESS FOR FEEDING CATS WITH CHRONIC KIDNEY DISEASE 1059
SUPPORTING NUTRITION BY PROMOTING ADEQUATE FOOD CONSUMPTION 1061
REFERENCES 1062
Controversies in Veterinary Nephrology: Renal Diets Are Indicated for Cats with International Renal Interest Society Chroni ... 1067
Key points 1067
INTRODUCTION: PATHOPHYSIOLOGY OF FELINE CHRONIC KIDNEY DISEASES AND GOALS OF DIETARY MANAGEMENT 1067
DIETARY MANAGEMENT IN CHRONIC KIDNEY DISEASE 1069
Protein 1069
Phosphorus 1075
Sodium 1076
Fatty acids 1077
Potassium 1078
Acid–Base Balance 1079
Energy Intake, Loss of Body Weight, and Body Condition 1080
Water 1082
Other Nutrients 1083
COMMENTARY: FUTURE DIRECTIONS 1083
SUMMARY 1085
REFERENCES 1087
Controversies in Veterinary Nephrology: Differing Viewpoints 1095
Key points 1095
REFERENCES 1098
Utilization of Feeding Tubes in the Management of Feline Chronic Kidney Disease 1099
Key points 1099
APPROPRIATE NUTRITION IS CRITICAL IN THE MANAGEMENT OF CHRONIC KIDNEY DISEASE 1100
MALNUTRITION IN PATIENTS WITH CHRONIC KIDNEY DISEASE 1100
CALCULATING CALORIE NEEDS 1102
ASSISTED ENTERAL FEEDING 1103
COMPLICATIONS ASSOCIATED WITH FEEDING TUBES 1106
ESOPHAGOSTOMY TUBE MAINTENANCE 1108
LONG-TERM TUBE MAINTENANCE 1108
SUMMARY 1109
REFERENCES 1110
Appendix 1. APPENDIX 1 ESOPHAGOSTOMY TUBE PLACEMENT 1111
Management of Proteinuria in Dogs and Cats with Chronic Kidney Disease 1115
Key points 1115
PROTEINURIA AS A PROGNOSTIC INDICATOR IN CHRONIC KIDNEY DISEASE 1116
NORMAL RENAL HANDLING OF PROTEIN 1116
LABORATORY TESTS FOR URINE PROTEIN 1117
CLINICAL ASSESSMENT OF PROTEINURIA 1118
INHIBITION OF THE RENIN–ANGIOTENSIN–ALDOSTERONE SYSTEM TO MANAGE PROTEINURIA 1119
Angiotensin-Converting Enzyme Inhibitors 1120
Angiotensin Receptor Blockers 1121
Combined Therapy with Angiotensin-Converting Enzyme Inhibitors and Angiotensin Receptor Blockers 1123
Aldosterone Breakthrough 1123
Aldosterone Receptor Antagonists 1124
Monitoring Drug Therapy 1124
Making Therapeutic Adjustments for Renin–Angiotensin–Aldosterone System Inhibitors 1124
Managing Hyperkalemia 1125
MANAGEMENT OF HYPERTENSION 1125
DIET 1126
RENAL BIOPSY 1126
IMMUNOSUPPRESSIVE AGENTS 1127
REFERENCES 1128
Update on Mineral and Bone Disorders in Chronic Kidney Disease 1131
Key points 1131
MINERAL AND BONE DISORDERS IN CHRONIC KIDNEY DISEASE 1131
Renal Secondary Hyperparathyroidism 1131
Renal Osteodystrophy 1134
Vessel and Tissue Mineralization 1135
TREATMENT OF CHRONIC KIDNEY DISEASE MINERAL AND BONE DISORDER 1135
Dietary Therapy 1137
Phosphate Binders 1137
Treating Hyperphosphatemic, Hypocalcemic Patients 1138
Treating Hyperphosphatemic, Normocalcemic Patients 1139
Treating Hyperphosphatemic, Hypercalcemic Patients 1141
CONTROLLING SERUM PARATHYROID HORMONE CONCENTRATION 1141
Vitamin D Analogues 1143
Calcimimetics 1144
Hemodialysis 1144
SUMMARY 1145
REFERENCES 1145
Does Secondary Renal Osteopathy Exist in Companion Animals? 1151
Key points 1151
INTRODUCTION 1151
Renal Secondary Hyperparathyroidism 1151
Prevalence of renal secondary hyperparathyroidism in patients with chronic kidney disease 1152
Bone Abnormalities Associated with Renal Secondary Hyperparathyroidism 1152
Renal osteodystrophy 1152
METHODS TO ASSESS BONE QUALITY 1153
Bone Mineral Density 1153
Porosity 1153
Mechanical Assessment of Bone Quality: Bending Tests 1153
RENAL OSTEODYSTROPHY IN HUMAN AND ANIMALS WITH CHRONIC KIDNEY DISEASE 1155
Renal Osteodystrophy in Human Patients with Chronic Kidney Disease 1155
Bone Abnormalities in Veterinary Patients with Chronic Kidney Disease 1155
Material Properties of the Cortical Bone 1156
Bone Geometry 1157
Mechanical Properties of the Cortical Bone 1157
PROPERTIES OF CANCELLOUS BONE 1158
Species Differences 1158
DOGS AND CATS AS A MODEL FOR RENAL OSTEODYSTROPHY IN HUMANS 1159
SUMMARY 1159
REFERENCES 1159
Update on Medical Management of Clinical Manifestations of Chronic Kidney Disease 1163
Key points 1163
MANAGEMENT OF HYPERTENSION 1163
Introduction/Etiology/Epidemiology 1163
Patient Evaluations 1164
Treatment Recommendations 1165
Evaluation of Outcome/Complications 1166
MANAGEMENT OF HYPOKALEMIA 1166
Introduction/Etiology/Epidemiology 1166
Patient Evaluations 1166
Treatment Recommendations 1167
Evaluation of Outcome/Complications 1167
MANAGEMENT OF ANEMIA 1168
Introduction/Etiology/Epidemiology 1168
Patient Evaluations 1168
Treatment Recommendations 1169
Evaluation of Outcome/Complications 1170
MANAGEMENT OF UREMIC DYSREXIA, NAUSEA, AND VOMITING 1170
Introduction/Etiology/Epidemiology 1170
Patient Evaluations 1171
Treatment Recommendations 1172
Evaluation of Outcome/Complications 1173
MANAGEMENT OF CONSTIPATION 1174
Introduction/Etiology/Epidemiology 1174
Patient Evaluations 1174
Treatment Recommendations 1175
Evaluation of Outcome/Complications 1176
BALANCING MEDICAL MANAGEMENT AND QUALITY OF LIFE 1177
REFERENCES 1177
Nephroureteral Obstructions 1183
Key points 1183
INTRODUCTION 1183
Diagnosis 1184
Decision-making 1185
Treatment 1186
Ureteral stenting 1186
Ureteral bypass 1190
REFERENCES 1191
Update on the Current Status of Kidney Transplantation for Chronic Kidney Disease in Animals 1193
Key points 1193
INTRODUCTION 1193
CANDIDATE PRESENTATION 1194
RECIPIENT EVALUATION 1194
Typing and Cross-Matching Incompatibilities 1195
Cardiovascular Disease and Hypertension 1196
Urinary Tract Evaluation 1197
Evaluation for Infectious Disease 1197
KIDNEY DONORS 1198
PREOPERATIVE TREATMENT 1199
Immunosuppressive Therapy 1199
Mesenchymal Stem Cell Therapy 1200
ANESTHETIC MANAGEMENT 1200
SURGERY 1202
POSTOPERATIVE MONITORING AND TROUBLESHOOTING PERIOPERATIVE COMPLICATIONS 1207
LONG-TERM MANAGEMENT AND COMPLICATIONS 1209
LONG-TERM COMPLICATIONS 1209
Acute Rejection 1209
Retroperitoneal Fibrosis 1211
Calcium Oxalate Urolithiasis 1211
Immunosuppressive Therapy 1212
Infection 1212
NEOPLASIA 1213
DIABETES MELLITUS 1213
COMPLICATIONS IN DOGS 1214
OUTCOME 1214
REFERENCES 1214
Index 1219