9 yr old MN DLH with 3-4 year hx of asymptomatic chronic nonregenerative anemia
Presented to E-clinic recently for inappetence, vomiting. PCV dropped from 24% to 20% on fluid therapy. U/A showed USG=1.055. No chemistry abnormalities reported. Has had negative FeLV/FIV tests in the past.
Abdominal US is wnl except for the kidneys. There is loss of normal corticomedullary structure, irregular capsule contour, and focal cortical echogenic lesions in both kidneys. The kidneys are not enlarged and the patient is not azotemic so neoplasia seems unlikely.
Could this be congenital renal dysplasia? Acquired renal disease/past renal insult with no loss of renal function? FIP?
Could this be related to the chronic years-long anemia?
4 responses to “Abnormal renal structure in 9 yr old mn DLH”
Severe renal changes on
Severe renal changes on ultrasound, (dysplasia, chronic kidney disease) yet normal renal function – well concentrated urine and no azotemia. This would imply that glomerulus and tubules are functioning to maintain renal function. With the appearance of the kidneys the interstitium is most likely affected and that is where eyrthropoietin is produced, hence a possible explanation for the anemia. However would still look for other causes first, especially if the anemia is regenerative.
Any prior insult to the kidney – infection, toxins. Ideally should biopsy the kidney as if progressive will result in renal failure as the tubules get caught up with the interstitial pathology.
4 responses to “Abnormal renal structure in 9 yr old mn DLH”
Severe renal changes on
Severe renal changes on ultrasound, (dysplasia, chronic kidney disease) yet normal renal function – well concentrated urine and no azotemia. This would imply that glomerulus and tubules are functioning to maintain renal function. With the appearance of the kidneys the interstitium is most likely affected and that is where eyrthropoietin is produced, hence a possible explanation for the anemia. However would still look for other causes first, especially if the anemia is regenerative.
Thank you, Remo. What type of
Thank you, Remo. What type of interstitial disease would cause this?
Any prior insult to the
Any prior insult to the kidney – infection, toxins. Ideally should biopsy the kidney as if progressive will result in renal failure as the tubules get caught up with the interstitial pathology.
Lots of infarcts and calculi
Lots of infarcts and calculi here causing the dystrophy.