Azotemia & Acute Kidney Injury

Gregory F. Grauer, DVM, MS, DACVIM (SAIM), Kansas State University

Sarah Guess, DVM, MS, Columbia River Veterinary Specialists, Vancouver, Washington

ArticleLast Updated October 20161 min readPeer Reviewed

History, Examination, & Laboratory Findings of CKD & AKI*

Findings	CKD	AKI
Weight loss, poor coat, poor body condition	+	-
Small, irregular kidneys (on radiography or palpation)	+	-
Nonregenerative anemia	+	-
Acidosis/hyperkalemia	-	+
Oliguria/anuria	-	+
Small, irregular kidneys with hyperechoic cortices with or without loss of corticomedullary junction (on ultrasonography)	+	-
Chronic history of polyuria/polydipsia or stage 1 CKD	+	-
Urine sediment changes compatible with tubular cell damage (eg, granular casts, renal tubular epithelial cells)	-	+
Relatively severe signs for magnitude of azotemia	-	+

*+ = presence more likely; - = presence less likely

EXAMPLE OF Fluid Volume Requirements for A 20-KG DOG WITH 8% DEHYDRATION & AKI

Hypothetical Comparison of TOTAL FLUID NEEDS in Normal, Oliguric, & Polyuric Dogs

	Normal	Oliguric	Polyuric
Insensible fluid needs	20 mL/kg/day	20 mL/kg/day	20 mL/kg/day
Sensible fluid needs (urine output)	40 mL/kg/day	6 mL/kg/day	165 mL/kg/day
Total	60 mL/kg/day	26 mL/kg/day	185 mL/kg/day

AKI = acute kidney injury,BP = blood pressure,CKD = chronic kidney disease,PCR = polymerase chain reaction,UP:C = urine protein:creatinine,USG = urine specific gravity

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Azotemia & Acute Kidney Injury

Gregory F. Grauer, DVM, MS, DACVIM (SAIM), Kansas State University

Sarah Guess, DVM, MS, Columbia River Veterinary Specialists, Vancouver, Washington

History, Examination, & Laboratory Findings of CKD & AKI*

EXAMPLE OF Fluid Volume Requirements for A 20-KG DOG WITH 8% DEHYDRATION & AKI

Hypothetical Comparison of TOTAL FLUID NEEDS in Normal, Oliguric, & Polyuric Dogs

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