Manual of Equine Anesthesia and Analgesia. Группа авторов
Чтение книги онлайн.
Читать онлайн книгу Manual of Equine Anesthesia and Analgesia - Группа авторов страница 47
![Manual of Equine Anesthesia and Analgesia - Группа авторов Manual of Equine Anesthesia and Analgesia - Группа авторов](/cover_pre1034366.jpg)
The collecting duct is under the influence of arginine vasopressin (anti‐diuretic hormone – ADH), which controls the final urine osmolality (concentration).
During states of dehydration, ADH is released from the posterior pituitary, resulting in the insertion of aquaporin channels into the membrane of the cells of the collecting duct.These channels allow the absorption of water, resulting in a concentrated urine.
Equine urine
Equine urine can be very cloudy and foamy, and rather viscous, depending on the horse's diet. (see Figure 5.1)
The cloudiness results from the high concentration of calcium carbonate crystals.Diets high in calcium (e.g. alfalfa) are associated with higher concentrations of calcium carbonate crystals in the urine.Excess dietary calcium is eliminated in the urine and feces.The majority of equine uroliths are composed of calcium carbonate.Figure 5.1 Image of a sample of horse urine. The urine appears cloudy and foamy which is a normal finding.
The foamy and viscous nature of equine urine is due to its high concentration of mucus.Gland‐like structures in the wall of the equine renal pelvis secrete a mucus‐like substance.Mucus has a lubricant function, and helps in preventing the formation of urinary stones from small calcium carbonate crystals.
B Renal blood flow and GFR
Renal blood flow (RBF)
Is approximately 20% of the cardiac output at rest, and is delivered to the kidneys via the renal arteries.
An uneven distribution exists within the kidney, as the renal cortex receives 90–95% of the blood.
These activities account for about 10% of the body's oxygen utilization.Up to 80% of renal oxygen consumption is used for the process of sodium reabsorption.
This high oxygen demand makes the kidney tubules susceptible to hypoxic damage, such as may occur with a decrease in perfusion during anesthesia.
Renal plasma flow (RPF)
Is the volume of plasma that flows through the kidney per unit time.
Blood cells and most proteins are too large to be filtered through Bowman's capsule.
The RPF is estimated by multiplying the RBF × (1 − hematocrit [HCT])
Filtration fraction (FF)
The FF is the fraction of RPF filtered across the glomerulus.Approximately 20% of the RPF enters the capsule.The remaining 80% continues through the renal circulation.
Glomerular filtration rate (GFR)
The GFR is the volume of filtrate formed by both kidneys per minute.
The GFR is equal to the RPF × FF.
The GFR is determined by:Renal blood flow.Neural and hormonal influences.Intrarenal autoregulation.Plasma oncotic pressure.
Autoregulation
This is the intrinsic ability of an organ to maintain normal blood flow despite changes in perfusion pressure.
Autoregulation is intrinsic to the kidneys.Pressures in the range 80–180 mmHg maintain RBF and GFR at steady states.
As pressure increases, flow remains constant if resistance increases proportionately, and vice versa.
Tubuloglomerular feedback (TGF)
The TGF is a local intrarenal negative feedback mechanism, and is important in regulating the GFR and urine excretion rate.
Within the distal convoluted tubule, specialized cells called the macula densa sense decreased sodium chloride concentrations within the tubular lumen.
This results in a cascade of events resulting in renin release (see Figure 5.2).
The tone of the glomerular arterioles is adjusted to control GFR.
Nitric oxide and adenosine are thought to have an important role in this mechanism.
C Urine formation
The formation of urine involves three renal processes:Glomerular filtration.Tubular reabsorption of filtrate.Tubular secretion.
These processes affect the urine volume and its components.
Urine formation is controlled by neurohormonal and physiologic factors regulating sodium and water reabsorption.
These controlling factors include aldosterone, arginine vasopressin, renin, angiotensin II, atrial natriuretic peptide, prostaglandins, catecholamines, arterial blood pressure, and stress.
D Urine volume in the horse
Example: A 450 kg horse (Assume a HCT of 40%)
Comments:
The GFR greatly exceeds the urine volume, indicating that about