Page 453 - WSAVA2017
P. 453

WSVA7-0546
HILL’S: NEPHROLOGY
MANAGEMENT OF IRIS STAGE 1 CKD – WHAT IS THE EVIDENCE
J. Bartges1
1The University of Georgia, Athens, GA, USA 30606
Following this presentation, the attendee should be able to
- define IRIS CKD stage 1
- describe methods for diagnosis of patients with IRIS CKD stage 1
- compare and contrast evidence for medical intervention of patients with IRIS CKD stage 1
WHAT IS IRIS STAGING FOR CKD?
Chronic kidney disease (CKD) implies irreversible failure that remains stable for a period of time but is ultimately progressive over some period of time. CKD may occur at any age, but incidence increases with increasing age.(1) The kidneys are involved with homeostasis; therefore, CKD affects many organ systems. Clinical signs involve primarily change in water balance (polyuria and polydipsia), gastrointestinal signs (anorexia,
hyporexia, halitosis, vomiting), and evidence of chronicity (weight loss, loss of body condition and muscle mass, unkempt appearance). Physical examination may reveal oral ulceration and halitosis, decreased muscle mass and body weight, dehydration, and small, irregular kidneys. Laboratory evaluation may reveal azotemia, inappropriately dilute urine, hyperphosphatemia, metabolic acidosis, and possibly hypokalemia, non- regenerative anemia, and calcium imbalance. Bacterial urinary tract infection may be present but is often
not associated with active urine sediment. Systemic arterial hypertension occurs in 65-80% of patients. The International Renal Insufficiency Society (http://www. IRIS-kidney.com) has developed staging system for animals with CKD and treatment based on staging.
(2) A diagnosis of CKD is made first and staging is accomplished by evaluating creatinine when patient
is well hydrated, urine protein-creatinine ratios (UPC),
and indirect arterial blood pressure determinations.
CKD is staged by magnitude of renal dysfunction and further modified (sub-staged) by presence or absence of proteinuria and/or hypertension. Proteinuria ONLY refers to renal proteinuria and not pre-renal or post-renal, based on UPC.
An Urban Experience
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