Felis ISSN 2398-2950

Kidney: ischemia

Synonym(s): Renal ischemia, ischaemia

Contributor(s): Penney Barber, Julien Bazelle

Introduction

  • Cause: multiple potential events that can lead to renal ischemia.
  • Signs: same as acute renal failure Kidney: acute renal failure.
  • Diagnosis: histopathology.
  • Treatment: supportive care only to try to prevent renal failure.
  • Prognosis: acute renal failure if renal ischemia not corrected quickly.

Pathogenesis

Etiology

Pathophysiology

  • Sudden impairment of renal blood supply → renal ischemia  →  decreased intracellular ATP (due to mitochondrial dysfunction)  →   decreased function of Na-K and Na-Ca ATP-ase pumps  →  increased intracellular Na and Ca  →  increased intracellular osmotic pressure  →  swelling of tubular cells and sludging and aggregation in renal blood vessels  →  further decrease in renal blood flow.
  • Renal ischemia → increase in oxygen free radical formation → further damage cell membranes (eg through lipid peroxidation).
  • Self-perpetuating secondary injuries during reperfusion injury. 
  • Severe damage to the renal cells  →  acute renal failure and/or chronic changes with fibrosis increasing risk for chronic renal failure Kidney: chronic kidney disease.

Timecourse

  • Acute but can progress to chronic kidney disease.

Diagnosis

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Treatment

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Prevention

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Outcomes

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Further Reading

Publications

Refereed papers

  • Recent references from PubMed and VetMedResource.
  • Brown C A, Rissi D R, Dickerson V M et al (2019) Chronic Renal Changes After a Single Ischemic Event in an Experimental Model of Feline Chronic Kidney Disease. Vet Pathol 56(4), 536-543 PubMed.  
  • Greenbarg E H, Jiménez D A, Nell L A et al (2018) Pilot study: use of contrast-enhanced ultrasonography in feline renal transplant recipients. J Feline Med Surg 20(4), 393-398 PubMed.  
  • Bland S K, Schmiedt C W, Clark M E et al (2017) Expression of Kidney Injury Molecule-1 in Healthy and Diseased Feline Kidney Tissue. Vet Pathol 54(3), 490-510 PubMed.    
  • Rosselli D D, Mumaw J L, Dickerson V et al (2016) Efficacy of allogeneic mesenchymal stem cell administration in a model of acute ischemic kidney injury in cats. Res Vet Sci 108, 18-24 PubMed.    
  • Schmiedt C W, Brainard B M, Hinson W et al (2016) Unilateral Renal Ischemia as a Model of Acute Kidney Injury and Renal Fibrosis in Cats. Vet Pathol 53(1), 87-101 PubMed.  
  • Keir I, Kellum J A (2015) Acute kidney injury in severe sepsis: pathophysiology, diagnosis, and treatment recommendations. J Vet Emerg Crit Care (San Antonio) 25(2), 200-209 PubMed.  
  • Hickey M C, Jandrey K, Farrell K S et al (2014) Concurrent diseases and conditions in cats with renal infarcts. J Vet Intern Med 28(2), 319-23 PubMed
  • Worwag S, Langston C E (2008) Acute intrinsic renal failure in cats: 32 cases (1997-2004). J Am Vet Med Assoc 232(5), 728-32 PubMed.  


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