Canis ISSN: 2398-2942

Kidney: ischemia

Synonym(s): Renal ischaemia

Contributor(s): Phil Nicholls, Julien Bazelle

Introduction

  • Cause: multiple potential events that can lead to renal ischemia.
  • Signs: shock, hyperthermia/hypothermia.
  • Diagnosis: depends on underlying cause.
  • Treatment: treat underlying cause.
  • Prognosis: acute renal failure if renal ischemia not corrected quickly.
  • See also renal failure Kidney: acute kidney injury (AKI).

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.

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.
  • Zahran H, Barakat N, Khater S et al (2019) Renoprotective effect of local sildenafil administration in renal ischaemia-reperfusion injury: A randomised controlled canine study. Arab J Urol 17(2), 150-159 PubMed.   
  • Lee G, Jeon S, Lee S K et al (2017) Quantitative evaluation of renal parenchymal perfusion using contrast-enhanced ultrasonography in renal ischemia-reperfusion injury in dogs. J Vet Sci 18(4),507-514 PubMed.    
  • Davis J, Raisis A L, Cianciolo R E et al (2016) Urinary neutrophil gelatinase-associated lipocalin concentration changes after acute haemorrhage and colloid-mediated reperfusion in anaesthetized dogs. Vet Anaesth Analg 43(3), 262-270 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.
  • Dong Y, Wang W, Cao J et al (2013) Quantitative evaluation of contrast-enhanced ultrasonography in the diagnosis of chronic ischemic renal disease in a dog model. PLoS One 8(8), e70337 PubMed.    
  • Lee J I, Son H Y, Kim M C (2006) Attenuation of ischemia-reperfusion injury by ascorbic acid in the canine renal transplantation. J Vet Sci 7(4), 375-379 PubMed.  
  • Lee J I, Kim M J, Park C S et al (2006) Influence of ascorbic acid on BUN, creatinine, resistive index in canine renal ischemia-reperfusion injury. J Vet Sci 7(1), 79-81 PubMed.  
  • Cylwik B et al (1985) Histological and biochemical changes in the dog kidney after renal artery embolization with Spongostan. Int Urol Nephrol 17 (3), 203-210 SpringerLink.
  • Lalli A F et al (1973) Selective canine renal infarction. Cleve Clin Q 40 (2), 75-77 PubMed.


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