Pathophysiology and treatment of kidney disease in cats
Abstract
Kidneys are responsible for the regulation of the body’s water, electrolyte and acid-base balance as well as excretion of metabolic waste products and foreign chemicals, glucose synthesis and erythropoietin production. Although kidney failure is a common disease affecting feline patients, an increased understanding of the disease and advances in treatment mean that cats are living longer after diagnosis. Renal disease can be acute or chronic, and is hallmarked by an elevated blood urea nitrogen and serum creatinine (azotaemia). It is important that cats with kidney failure receive a complete diagnostic work-up in order to determine the underlying cause; tailored treatment includes fluid therapy, correcting acid-base and electrolyte abnormalities, treating hypertension and anaemia, renal transplantation, intermittent haemodialysis and continuous renal replacement therapy.
Kidney failure is one of the most common diseases that affects feline patients. With advances in treatment options and the understanding of kidney disease, cats are living longer and more productive lives after being diagnosed with this condition. This article outlines the physiology of the kidneys, the pathophysiology of acute and chronic renal disease and treatment options available to feline patients.
The kidneys filter approximately 20% of the body’s blood (Aspinall and O’Reilly, 2006). They are responsible for a myriad of tasks, including:
Each bean-shaped kidney contains millions of functional units called nephrons, which filter blood through the glomerular filtration (GF) process and produce urine. A nephron is a long tubule that consists of five main parts (Nelson and Couto, 1998):
As blood enters into the glomerular capsule, high pressures force fluid and small molecules out while larger particles (blood cells, plasma and protein molecules) are retained in the blood and continue through (Nelson and Couto, 1998). Within the glomerular capsule lies the glomerulus, a cluster of blood vessels through which blood passes for filtra-tion (Aspinall and O’Reilly, 2006); the glomerular filtration rate (GFR) is the rate the fluid is filtered through the kidneys.
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