|Purred: Fri Nov 27, '09 12:28am PST |
|How your kidneys work and the basics of CRF and treatment
Your blood goes through your kidneys about 20-25 times a day (that’s for humans and is probably more for cats as our heart rate is faster). Each time the blood goes through about 20% of it get "scrubbed" by the kidneys so your blood gets completely scrubbed about 4-5 times a day.
Your kidneys get rid of waste products and keep all the ingredients in your blood at the right levels. They work by filtering your blood and then making sure the right stuff either goes back into your blood stream or into your urine/pee. When you pee this gets rid of waste products.
When blood flows into the kidney it is filtered. All the big stuff like blood cells stays in your blood and the rest (water, ions like calcium, sugars and small proteins) go into tiny tubes in the kidney (called nephrons). Inside the kidney this stuff is either reabsorbed and but back into the blood (water, glucose, proteins, ions) or excreted and put into urine (some water, waste products/excess ions).
Your kidneys also help control your blood pressure. They manage the volume of your blood (by adjusting the concentration of salt in your blood) and produce a hormone that tells your blood vessels to constrict.
Your kidneys can lose about 75% of their function before they are unable to keep everything in balance and you start to see the symptoms of kidney disease.
CRF (chronic renal failure) happens gradually over time. As you age the filters and tiny tubes in your kidneys gradually get damaged and stop working and this can happen faster if you have high blood pressure which puts them under pressure or diabetes which makes them brittle.
The symptoms of CRF result from the failure of the processes above. The kidneys leak if the filters don't work properly and you'll start to see proteins in your urine. The kidneys can't filter out all the waste products in your blood so you'll see higher levels or waste products - for instance your blood tests will show high BUN and creatinine which are waste products of protein. The kidneys can't reabsorb/excrete ions properly and you'll have too high/low levels of ions like calcium, bicarbonate, phosphorus.
Treatment of CRF has 3 main components and they can help you live a lot longer.
1) Keep you hydrated so that your kidneys can work as well as possible to filter out waste products. This includes sub-Q fluids, making sure you drink water using fountains etc and eating wet food if possible.
2) Modifying your diet so that there are fewer waste products put into your blood that the kidneys need to filter. This is usually done with special cat food with low protein, low phosphorus levels etc.
3) Medicines to replace the functions of the kidneys. This includes things to get stuff out of your blood like meds to reduce phosphorus levels, to add stuff to your blood like bicarbonate or blood pressure meds.
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