Fluid therapy for acute and chronic renal failure.
Animals with renal failure have a number of fairly predictable metabolic abnormalities. They are commonly presented to the veterinarian in a state of negative water balance, although prior fluid therapy in an oliguric patient may result in overhydration. Animals with oliguric ARF have sodium retention; those with polyuric ARF have increased urinary sodium loss. Chronic renal failure does not necessarily affect the ability of the renal tubule to conserve or excrete sodium, although the response to changes in sodium load is much slower than in the normal animal. Potassium retention occurs in oliguric ARF and potassium wasting in polyuric ARF; potassium balance is approximately normal in animals with CRF. Both ARF and CRF cause metabolic acidosis, although the acid-base status in a given animal will be affected by respiratory compensation, as well as other problems such as vomiting. Calcium levels are usually normal to slightly decreased in renal failure, whereas phosphorus levels are generally increased. The basic principles of fluid therapy should be used when constructing a plan for such therapy in an animal with renal failure. Intravenous administration of fluids is almost always necessary. The choice of the type of fluid, solutes, and electrolytes to be administered is based on the predicted abnormalities associated with renal failure as well as the laboratory abnormalities in the animal. Careful monitoring of the patient and periodic assessment of various laboratory parameters are necessary in order to make appropriate adjustments in fluid therapy.
Ross
L A
LA
Department of Medicine, Tufts University School of Veterinary Medicine, North Grafton, Massachusetts.
D058186:Acute Kidney Injury / Q000378:metabolism / Q000628:therapy / Q000662:veterinary*; D000818:Animals; D002371:Cat Diseases / Q000378:metabolism / Q000628:therapy*; D002415:Cats; D004283:Dog Diseases / Q000378:metabolism / Q000628:therapy*; D004285:Dogs; D005440:Fluid Therapy / Q000662:veterinary*; D007676:Kidney Failure, Chronic / Q000378:metabolism / Q000628:therapy / Q000662:veterinary*