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Early detection of chronic kidney disease
/content/chapter/10.22233/9781910443354.chap10
Early detection of chronic kidney disease
- Authors: Natalie Finch and Reidun Heiene
- From: BSAVA Manual of Canine and Feline Nephrology and Urology
- Item: Chapter 10, pp 130 - 142
- DOI: 10.22233/9781910443354.10
- Copyright: © 2017 British Small Animal Veterinary Association
- Publication Date: January 2017
Abstract
Early identification of patients with chronic kidney disease is considered important for implementing therapeutic interventions aimed at slowing further progression of the disease. This chapter describes the diagnostic techniques including historical findings, the clinical examination, laboratory diagnosis and imaging. Measurement of glomerular filtration rate is discussed in detail.
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Figures
/content/figure/10.22233/9781910443354.chap10.ch10fig1
10.1
Exponential relationship between creatinine concentration and glomerular filtration rate (GFR) in cats, indicating that a large decrease in GFR results in only a small corresponding increase in creatinine concentration. (Adapted from
Finch, 2014
) © 2017 British Small Animal Veterinary Association
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10.1
Exponential relationship between creatinine concentration and glomerular filtration rate (GFR) in cats, indicating that a large decrease in GFR results in only a small corresponding increase in creatinine concentration. (Adapted from
Finch, 2014
)
/content/figure/10.22233/9781910443354.chap10.ch10fig2
10.2
Creatinine concentration versus bodyweight in 567 dogs of various sizes. (Courtesy of R Heiene, J Aasen, C Trangerud and E Teske) © 2017 British Small Animal Veterinary Association
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10.2
Creatinine concentration versus bodyweight in 567 dogs of various sizes. (Courtesy of R Heiene, J Aasen, C Trangerud and E Teske)
/content/figure/10.22233/9781910443354.chap10.ch10fig3
10.3
Analytical values and reference ranges in plasma/serum creatinine in 10 healthy dogs (plotted on x-axis). Three aliquots from each of the dogs were analysed at 10 European referral laboratories. While the analytical variability was low, the percentage of samples classified as abnormal varied from 0 to 37%, based upon the variability in reference ranges between laboratories. (Reproduced from
Ulleberg et al., 2011
with permission from Acta Veterinaria Scandinavica) © 2017 British Small Animal Veterinary Association
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10.3
Analytical values and reference ranges in plasma/serum creatinine in 10 healthy dogs (plotted on x-axis). Three aliquots from each of the dogs were analysed at 10 European referral laboratories. While the analytical variability was low, the percentage of samples classified as abnormal varied from 0 to 37%, based upon the variability in reference ranges between laboratories. (Reproduced from
Ulleberg et al., 2011
with permission from Acta Veterinaria Scandinavica)
/content/figure/10.22233/9781910443354.chap10.ch10fig5
10.5
Structure of the glomerulus. (Reproduced from
Finch, 2014
with permission from the Journal of Feline Medicine and Surgery) © 2017 British Small Animal Veterinary Association
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10.5
Structure of the glomerulus. (Reproduced from
Finch, 2014
with permission from the Journal of Feline Medicine and Surgery)
/content/figure/10.22233/9781910443354.chap10.ch10fig6
10.6
Structure of the nephron. (Reproduced from
Finch, 2014
with permission from the Journal of Feline Medicine and Surgery) © 2017 British Small Animal Veterinary Association
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10.6
Structure of the nephron. (Reproduced from
Finch, 2014
with permission from the Journal of Feline Medicine and Surgery)
/content/figure/10.22233/9781910443354.chap10.ch10fig8
10.8
Pharmacokinetic models used to determine the area under the plasma concentration versus time curve. (a) One-compartment; minimum number of samples = 2. (b) Two-compartment; minimum number of samples = 4. (c) Non-compartment; minimum number of samples is unknown, however, the use of three gives inaccurate glomerular filtration rate estimation. © 2017 British Small Animal Veterinary Association
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10.8
Pharmacokinetic models used to determine the area under the plasma concentration versus time curve. (a) One-compartment; minimum number of samples = 2. (b) Two-compartment; minimum number of samples = 4. (c) Non-compartment; minimum number of samples is unknown, however, the use of three gives inaccurate glomerular filtration rate estimation.
/content/figure/10.22233/9781910443354.chap10.ch10fig9
10.9
Plasma concentration versus time curve indicating the missing area under the curve (AUC) associated with the slope–intercept method. The slope–intercept method of determining plasma clearance relies on a limited number of samples (generally three) collected during the elimination phase of the clearance curve (usually starting 60 minutes after administration of the filtration marker). As the initial distribution exponential is ignored, this creates a ‘missing area under the curve’ (blue circle), leading to an underestimation in the calculated AUC and hence overestimation of the glomerular filtration rate (GFR) (because GFR is calculated as dose/AUC). © 2017 British Small Animal Veterinary Association
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10.9
Plasma concentration versus time curve indicating the missing area under the curve (AUC) associated with the slope–intercept method. The slope–intercept method of determining plasma clearance relies on a limited number of samples (generally three) collected during the elimination phase of the clearance curve (usually starting 60 minutes after administration of the filtration marker). As the initial distribution exponential is ignored, this creates a ‘missing area under the curve’ (blue circle), leading to an underestimation in the calculated AUC and hence overestimation of the glomerular filtration rate (GFR) (because GFR is calculated as dose/AUC).