Difference between revisions of "Azotaemia"
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| − | ==Introduction== | + | == Introduction == |
| − | |||
| − | ==Clinical Significance== | + | Azotaemia refers to an increase in the blood concentrations of '''urea''' and '''creatinine'''. Azotaemia occurs almost exclusively with renal failure that results in an inability to excrete these two metabolic products. [[Urea]] and [[Creatinine]] vary in the extent of the increase induced by renal pathologies (creatinine can show substantial increases from baseline, whereas smaller increases in urea are significant as levels generally increase by a much smaller factor) and also the timing of the increase - creatinine levels will rise and fall more quickly than changes in urea and can therefore be more useful in monitorinngngngg response to treatment. |
| − | Azotaemia may cause the clinical syndrome of [[Uraemia|'''uraemia''']], affecting multiple organ systems. | + | |
| − | ===Pre-renal azotaemia=== | + | == Clinical Significance == |
| − | This occurs when the kidney receives insufficient oxygen via blood flow to maintain its normal metabolic processes. Conditions that can cause this include: | + | |
| − | *'''Dehydration/hypovolaemia''', which reduces renal blood flow. | + | Azotaemia may cause the clinical syndrome of [[Uraemia|'''uraemia''']], affecting multiple organ systems. The causes of azotaemia are usually divided into pre-renal, renal and post-renal: |
| − | *'''Heart failure''' which results in a reduced cardiac output, thereby reducing renal blood flow. | + | |
| − | *'''Anaemia''' reduces the amount of oxygen delivered to the kidneys. | + | === Pre-renal azotaemia === |
| + | |||
| + | This occurs when the kidney receives insufficient oxygen via blood flow to maintain its normal metabolic processes. Conditions that can cause this include: | ||
| + | |||
| + | *'''Dehydration/hypovolaemia''', which reduces renal blood flow. | ||
| + | *'''Heart failure''' which results in a reduced cardiac output, thereby reducing renal blood flow. | ||
| + | *'''Anaemia''' reduces the amount of oxygen delivered to the kidneys. | ||
*'''Portal hypertension''' may result in splanchnic pooling of blood and reduced renal blood flow. | *'''Portal hypertension''' may result in splanchnic pooling of blood and reduced renal blood flow. | ||
| − | ===Renal azotaemia=== | + | === Renal azotaemia === |
| − | This occurs following a direct insult to the kidney from several possible causes including: | + | |
| − | *'''Exogenous toxins''' including heavy metals, [[Aminoglycosides|aminoglycosides]], [[Tetracyclines|tetracyclines]], polymixin B, cisplatin, antifreeze ([[Ethylene Glycol Toxicity|ethylene glycol]]), lilies in cats and grapes in dogs. | + | This occurs following a direct insult to the kidney from several possible causes including: |
| − | *'''Endogenous toxins''' including haemoglobin, myoglobin and calcium. | + | |
| − | *Infections such as '''pyelonephritis''', '''interstitial nephritis''' (as caused by [[Leptospirosis - Cats and Dogs|''Leptospira spp.'']] or '''granulomatous nephritis''' (as caused by the dry form of [[Feline Infectious Peritonitis]]). | + | *'''Exogenous toxins''' including heavy metals, [[Aminoglycosides|aminoglycosides]], [[Tetracyclines|tetracyclines]], polymixin B, cisplatin, antifreeze ([[Ethylene Glycol Toxicity|ethylene glycol]]), lilies in cats and grapes in dogs. |
| − | *'''Glomerulonephritis''' and '''[[Amyloidosis|amyloidosis]]'''. | + | *'''Endogenous toxins''' including haemoglobin, myoglobin and calcium. |
| + | *Infections such as '''pyelonephritis''', '''interstitial nephritis''' (as caused by [[Leptospirosis - Cats and Dogs|''Leptospira spp.'']] or '''granulomatous nephritis''' (as caused by the dry form of [[Feline Infectious Peritonitis]]). | ||
| + | *'''Glomerulonephritis''' and '''[[Amyloidosis|amyloidosis]]'''. | ||
*'''Neoplasia''', notably [[Adenocarcinoma|adenocarcinoma]] in dogs and [[Lymphoma|lymphoma]] in cats. | *'''Neoplasia''', notably [[Adenocarcinoma|adenocarcinoma]] in dogs and [[Lymphoma|lymphoma]] in cats. | ||
| − | ===Post-renal azotaemia=== | + | === Post-renal azotaemia === |
| − | This occurs following obstructions within the urinary tract: | + | |
| − | *'''Urolithiasis''' | + | This occurs following obstructions within the urinary tract: |
| − | *'''Rupture of the urinary tract''', often due to trauma and causing [[Peritonitis - Cats and Dogs|uroabdomen]]. | + | |
| + | *'''Urolithiasis''' | ||
| + | *'''Rupture of the urinary tract''', often due to trauma and causing [[Peritonitis - Cats and Dogs|uroabdomen]]. | ||
*'''[[Neoplasia - Pathology|Neoplasia]]''', including transitional cell carcinoma of the bladder and prostatic neoplasia. | *'''[[Neoplasia - Pathology|Neoplasia]]''', including transitional cell carcinoma of the bladder and prostatic neoplasia. | ||
| − | + | [[Category:Blood_Biochemistry_Changes]] [[Category:Urological_Diseases_-_Dog]] | |
| − | [[Category: | ||
| − | [[Category: | ||
Revision as of 15:13, 25 February 2011
Introduction
Azotaemia refers to an increase in the blood concentrations of urea and creatinine. Azotaemia occurs almost exclusively with renal failure that results in an inability to excrete these two metabolic products. Urea and Creatinine vary in the extent of the increase induced by renal pathologies (creatinine can show substantial increases from baseline, whereas smaller increases in urea are significant as levels generally increase by a much smaller factor) and also the timing of the increase - creatinine levels will rise and fall more quickly than changes in urea and can therefore be more useful in monitorinngngngg response to treatment.
Clinical Significance
Azotaemia may cause the clinical syndrome of uraemia, affecting multiple organ systems. The causes of azotaemia are usually divided into pre-renal, renal and post-renal:
Pre-renal azotaemia
This occurs when the kidney receives insufficient oxygen via blood flow to maintain its normal metabolic processes. Conditions that can cause this include:
- Dehydration/hypovolaemia, which reduces renal blood flow.
- Heart failure which results in a reduced cardiac output, thereby reducing renal blood flow.
- Anaemia reduces the amount of oxygen delivered to the kidneys.
- Portal hypertension may result in splanchnic pooling of blood and reduced renal blood flow.
Renal azotaemia
This occurs following a direct insult to the kidney from several possible causes including:
- Exogenous toxins including heavy metals, aminoglycosides, tetracyclines, polymixin B, cisplatin, antifreeze (ethylene glycol), lilies in cats and grapes in dogs.
- Endogenous toxins including haemoglobin, myoglobin and calcium.
- Infections such as pyelonephritis, interstitial nephritis (as caused by Leptospira spp. or granulomatous nephritis (as caused by the dry form of Feline Infectious Peritonitis).
- Glomerulonephritis and amyloidosis.
- Neoplasia, notably adenocarcinoma in dogs and lymphoma in cats.
Post-renal azotaemia
This occurs following obstructions within the urinary tract:
- Urolithiasis
- Rupture of the urinary tract, often due to trauma and causing uroabdomen.
- Neoplasia, including transitional cell carcinoma of the bladder and prostatic neoplasia.