Chronic Renal Failure-Causes, Clinical Findings, Treatments and Prognosis.

The research paper discusses chronic kidney disease (CKD) in horses, which is uncommon but can be serious, and is often characterized by nonspecific symptoms like weight loss and edema. It also delves into more precise methods of assessing kidney functionality and recommends strategies to slow the disease’s progression, largely centered on diet and medication management.

Clinical Findings and Causes

The causes of CKD in horses include:

• Tubulointerstitial disease: An inflammation or scarring within the kidneys.
• Glomerulonephritis: A type of kidney disease where the kidneys’ tiny filters called glomeruli become inflamed.
• Pyelonephritis: A type of urinary tract infection where one or both kidneys get infected.
• Nephrolithiasis: The condition of having kidney stones.

Typical symptoms of CKD in horses involve nonspecific signs such as weight loss, frequent urination and increased thirst (polyuria/polydipsia), and edema in the lower abdomen. Other less common symptoms could range from a poor appetite and performance, a dull coat, mouth ulcers, gastrointestinal ulcers, gingivitis, dental tartar to diarrhea. In rare instances, horses might also develop forebrain signs, indicating a neurological condition apart from CKD.

Diagnosis of CKD

The paper discusses how a rise in creatinine levels might not occur until about 2/3rd of kidney function is lost. Therefore, to more accurately diagnose the condition, the study proposes estimating the glomerular filtration rate (eGFR), which measures the kidneys’ filtering capacity. This can be done by measuring iohexol clearance time in combination with the protein content in the urine.

Treatment and Prognosis

The progression of CKD can be slowed down predominantly through dietary changes and the avoidance of nephrotoxic drugs, which can harm the kidneys. Although the paper does not delve into specifics about these treatments, this general approach highlights the importance of maintaining a healthy diet and careful drug use in horses diagnosed with CKD.