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Cret, Set, Go- Managing Kidney-Associated Dysfunctions

In today’s blog, we are going to look at one important pair of organs which acts as a filtering system that retains the essential products while discarding the unwanted waste products in the form of urine. Yes, you must have guessed the organ by now, it’s the kidneys! These two organs are situated on either side of the midline and work 24×7 to ensure all the waste product from the body which is formed constantly has a way out of the body. Kidneys also ensure that all useful items such as glucose are retained and not expelled. Thus, there is homeostasis or steady state maintenance with the fine tuning of all the organ systems, especially the renal system of which the kidneys form the core.

‘Bones can break, muscles can atrophy, glands can loaf, even the brain can go to sleep without immediately endangering one’s survival; but should the kidneys fail, neither bone, muscles, glands nor brain could carry on’ -Horner Smith

In today’s blog, we are going to have a look at various reasons and problems with respect to the kidney-renal system as well as the parameters through which we assess the kidney function, the outcome and cure perspectives of kidney-associated dysfunctions.

Kidney Role And Functions

Kidneys have a widespread role to play in our bodies, and in fact, kidneys are at the crux of all body systems. With our blood producing waste each second, it becomes essential for these products to find their way out. Let us have a quick glance at all the normal functioning of the kidneys, as when this balance of functioning is disturbed due to certain kidney diseases, various signs and symptoms are manifested, which in turn, turns into a big malady.

  1. Maintain the fluid balance of the body
  2. Help maintain blood pressure via the renin-angiotensin-aldosterone system
  3. Helps to retain useful substances such as glucose
  4. The kidney works to discard or excrete unwanted toxic substances such as urea
  5. The kidney also produces Erythropoietin which works to produce red blood cells, or RBCs
  6. It also helps to maintain electrolyte balance by proper control [retention and excretion] of ions such as Na, K, etc.
  7. It filters blood all the time to make sure no waste product is being accumulated.
  8. Kidneys also activate Vitamin D

Deranged Function Of Kidney: Faqs

Q.1 What is Kidney Dysfunction?

carry out the afore-mentioned normal role. This malfunctioning of the kidneys could be of three types- Mild, Moderate, and Severe. Also, it could be acute or sudden in nature v/s chronic or slow to manifest in nature.

A. Acute Kidney Dysfunction

This sudden kidney dysfunction is otherwise known as acute kidney injury or AKI which occurs due to certain kidney insults. AKI is mostly attributed to the ingestion of certain toxic substances, mostly medicines or plant-origin toxins are responsible for AKI.

AKI is again of three forms which are based on the causative factors:

1) Pre-Renal Causes:

Here the causative factor for renal injury lies prior to the kidneys or apart from the renal system.

  • Due to excessive dehydration
  • Due to excessive fluid loss and electrolyte losses
  • Due to some ongoing heart disease

These conditions are reversible in the initial stages, wherein the culprit of dysfunction is caught early on.

2) Renal Causes:

Here the causative factor for renal injury lies in the kidney itself.

  • Ischemic Insult
  • Drugs Ingestion in higher quantities or contraindicated in general, e.g., Sulphonamides, Polymyxin, AMB, Gentamycin, etc.
  • Chemical Ingestion, e.g., Carbon tetrachloride, Ethylene glycol, Oxalic Acid, Phenol, Pesticides, etc
  • Metal Toxicities, e.g., Lead, Mercury, Arsenic, Cadmium, Bismuth, etc.
  • Due to acute glomerulo-nephritis disease
  • Blood transfusion within unmatched blood group type.
  • Pesticides and herbicides, too, can be injurious to the kidneys.
  • Harmful plants such as lily
  • Aspirin, Ibuprofen, and other OTC human drugs

3) Post-Renal Causes:

Here the causative factors lie post-kidneys

  • Obstruction of the ureter by stones [it may be unilateral or bilateral in nature]
  • Tumour which is occluding the outflow of urine
  • Obstruction of urine outflow from the bladder due to an enlarged prostate

B. Chronic Renal Failure

This is an obstinate problem and prognosis, or the outcome can be bad in some cases. Most commonly, the causative factors for chronic or slow course kidney failure are-

  • Glomerulonephritis [owing to antigen-antibody reactions]
  • Inflammation due to bacteria/virus/protozoa/helminth pathogens and chemicals
  • Chronic Kidney failure can be caused due to some concurrent ongoing disease such as Hepatitis, Filariasis, Lupus (auto-immune disease), or even diabetes.
  • Some heavy metals too can cause slow damage to the kidneys culminating in renal failure

Q2. What are the signs and symptoms one can look out for?

1. The most common sign one can evidently observe is Anorexia: Anorexia is a condition wherein your pet refuses to eat anything, they might drink water depending on individuality. Usually, this inappetence or anorexic episode starts suddenly, where your pet might suddenly, out of the blue, refuse to eat, or they may gradually stop eating food. If your pet is not eating for more than a day, it’s time to take your pet to the vet.

2. Behavioural Change is evident: Your pet might try to hide under the bed, lie down prostrated, seems dull and weak, and is depressed. All these signs are evident whenever your pet Is sick.

3. Urinary Output: Urine may be produced in normal quantities in the earlier stages of kidney failure, however, as the disease process progresses, there might be less output of urine to no output of urine in the end stages. It is therefore warranted to get your pets evaluated at the earliest if any of the signs and symptoms are observed by you.

4. Blood Test: Your veterinarian would conduct some blood tests to have a quick look at the kidney functioning of your pet. Certain parameters, such as Blood Urea nitrogen or the BUN along with creatinine are evaluated in case of suspected kidney pathology. BUN and Creatinine are usually excreted out in normal healthy kidneys, but in certain cases, these waste products are unable to find their way out of the body, thereby piling up in the blood thus hinting towards a possible kidney dysfunction.
Other values that are usually checked in the blood apart from BUN and Creatinine are electrolyte levels i.e., levels of Calcium, Potassium, Chlorine, Bicarbonates, etc.

The other commonly observed hemogram changes could be anaemia, increased number of leucocytes or white blood cells, and evident changes in blood calcium and potassium levels.

5. Urine Analysis is done to have a look at the urine and its constituents. Sediment or urinary deposits are evaluated for the presence of bacteria, pus, crystals, casts etc. also, the presence of white blood cells, red blood cells, and epithelial cells are checked, which can effectively rule out or rule in haemorrhage/ other ongoing pathology. The specific Gravity of the urine is evaluated as well, which differs in various conditions. Alongside this, the urine is cultured for the detection of bacteria [that may have caused urine infection or renal dysfunction].

6. Radiography or Xray: Radiographs help to evaluate the kidney shape/ size and crystals that are radio-opaque, which may have obstructed the urinary tract or may have set up a nidus for infection.

7. Ultrasonography:this is a warranted test in case of kidney dysfunction. This test helps to locate the exact problem. Through USG, various parenchymatous changes can be ruled out or ruled in. this test is evidently better than Radiography as it provides better information about the kidneys.

The Treatment Factor:

The treatment protocol varies considerably owing to the fact that no two animals are the same and that there are variations in the types of kidney dysfunction. treatment factor always differs and evolves based on the outcome and the course of the disease process. The treatment protocol is essentially aimed at improving the lifestyle quality of pets and protecting the remaining parts of the kidney, which helps preserve kidney functions. USG and other diagnostic tests help us to connect the dots and predict the outcome and course of the disease process. In some chronic cases of kidney failure due to disease or infection, coupling up with environmental factors such as old age and concurrent other diseases can aggravate the conditions, and the outcome may not be as bright as expected. Nevertheless, the treatment protocol is aimed at-

  1. Improving kidney functioning
  2. Correct the Fluid Deficit
  3. Correcting the electrolyte imbalance is one of the major targets in the treatment protocol
  4. To manage Anaemia by erythropoietin/darbepoetin shots
  5. Vitamins/Mineral and Antibiotics as required [case-based needs]
  6. Flush out the waste products with aggressive fluid therapy
  7. Conjunctive homeopathy therapy, too, can help out patients tremendously. Cretigo for pets is one such homeopathy medicine that helps to improve kidney function and is a great supportive therapy along with the traditional medicinal protocol.

Kidney Diseases can be quite a task to manage, but quick therapeutic management makes the road to recovery very easy. Individuals with kidney disease who are able to obtain treatment early experience a higher quality of life. Proper treatment protocols and a conjunctive holistic approach to any disease can aid in better prognosis, happier pets, and satisfied pet parents.

HAPPY PETS FOR A HAPPY YOU

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