Chronic renal failure causes difficult to pinpoint - DVM
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Chronic renal failure causes difficult to pinpoint
The top 13 questions addressed


DVM InFocus


Q: How do I diagnose CRF early or in its most treatable stages?

A: Annual or semi-annual health examinations that include clinicopathologic evaluations in middle-aged and older patients are an excellent way to document trends compatible with declining renal function. Data flow charts facilitate observation of trends and are recommended. Decreases in body weight, packed cell volume, and urine-specific gravity over time, for example, can occur in patients with subclinical renal dysfunction. Conversely, increases in serum urea nitrogen, creatinine, phosphorus and microalbuminuria/proteinuria (even when these increases remain within the laboratory normal range) might be early indicators of declining renal function. In patients with diminished urine concentrating ability, urine should be cultured periodically due to the diminished antibacterial properties of minimally concentrated urine. An ultrasound examination of the kidneys is indicated if trends in the above data are compatible with developing renal insufficiency failure.

Dr. Grauer earned his DVM degree from Iowa State University in 1978. He then completed his postgraduate training (internship, residency and MS degree) at Colorado State University between 1978 and 1982. Dr. Grauer obtained his specialty board certification in internal medicine in 1983. After his postgraduate training, Dr. Grauer was a member of the faculty at the School of Veterinary Medicine, University of Wisconsin for seven years and then returned to the Department of Clinical Sciences at Colorado State University where he served as professor and section chief of small animal medicine until 2000. Dr. Grauer also has served as president and chairman of the Board of Regents of the American College of Veterinary Internal Medicine. Currently, Dr. Grauer is professor and head of the Department of Clinical Sciences at the College of Veterinary Medicine, Kansas State University. His interests in clinical medicine and research involve the small animal urinary system.


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