Diagnostic and Therapeutic approach to a Chronic Kidney Diseases in Dogs

Abstract

Chronic Kidney Disease (CKD) is defined as the presence of structural or functional abnormalities in one or both kidneys that have been present for an extended period usually from three months or more. Nephron damage associated with CKD is usually irreversible and progressive and characterized by a wide spectrum of disease, ranging from a minor structural lesion in a single kidney to extensive loss of nephrons affecting both kidneys (Polzin, 2011).CKD is a major cause of morbidity and mortality, especially in older dogs and cats, which were recorded with an overall incidence of 1- 3 per cent in cats and 0.5 – 1.5 per cent in dogs (Brown, 2007).  Azotemia is defined as an abnormal concentration of urea, creatinine, and other nonprotein nitrogenous substances in blood, plasma, or serum. Azotemia is a laboratory finding with several fundamentally different causes. Since non-protein nitrogenous compounds (including urea and creatinine) are endogenous substances, abnormally elevated concentrations in serum may be caused by an  increased rate of production (by the liver for urea; by muscles for creatinine), or by a decreased rate of loss (primarily by the kidneys).  When the structural and functional integrity of both kidneys has been compromised to such a degree that polysystemic signs of kidney failure are clinically manifested, the relatively predictable symptom complex called uremia appears, regardless of underlying cause. In some instances, uremic crises may suddenly be precipitated by prerenal disorders or, less commonly, postrenal disorders in patients with previously compensated primary kidney failure. Uremia is characterized by multiple physiologic and metabolic alterations that result from impaired kidney function.