Determination of the reference interval of the C-reactive protein/albumin ratio and its efficiency, CRP and albumin as prognostic markers in dogs

Abstract

The objective of this research was to creates a reference interval for C-reactive protein (CRP)/albumin ratio (CAR) in the canine species and to analyze the potential of CRP, albumin and the relationship between both, to serve as indicators of disease severity, length of hospital stay (LoS) and mortality in this species. For this, an outcome study was conducted in a Veterinary Teaching Hospital in southern Brazil. One hundred ninety dogs were included randomly, without distinction of gender, age, or breed, from June 2013 to November 2016. Plasma was collected from them and analyzed for assessment of CRP and albumin. The reference range stipulated for CAR in dogs was 0.36-0.60, as determined by the confidence interval of mean resamplings (in percentiles). The frequencies mean, and standard deviations of the variables, correlation analysis, and comparative analysis (Kruskal-Wallis in α = 5%) were calculated. Elevation (above reference) of CAR was determined to be proportional to the severity of the underlying disease, and CRP means were reasonable. Besides, hypoalbuminemia was indicative of systemic disease, but not of severity. Thus, CAR was a better marker of disease severity than were CRP and albumin, analyzed separately. Concerning LoS, there was a positive correlation with CAR (p<0.01) in patients, and the same was not observed with CRP and albumin. Concerning mortality, hypoalbuminemia was the only marker valid in animals with a critical illness (p=0.04). In conclusion, CAR is a better marker of disease severity and LoS in dogs than are CRP and albumin analyzed separately.

Evaluation of plasma prealbumin as a novel inflammatory biomarker in dogs: a pilot study

“…Compared with the plasma albumin concentration, the plasma PAB concentration was significantly decreased in group B. Albumin is a negative APP synthesized in hepatocytes ( 18 ). The reasons for the deceased plasma albumin concentration in inflammation have been shown to be due to leakage from the intravascular compartment caused by increased vascular permeability, denaturation at sites of inflammation, reduced synthesis in the hepatic parenchyma, and degradation of albumin bound to toxins ( 12 , 18 , 27 ). Although albumin has been reported to be a useful, easy, and inexpensive parameter for detecting inflammatory diseases in dogs, it is a slow-reacting negative APP in dogs ( 18 ).…”

“…Therefore, it may be useful as an indicator in cases in which rapid therapeutic intervention must be assessed. Recent human and veterinary medicine studies have revealed that evaluating both positive APPs and negative APPs in patients may be better for confirming the degree of inflammation and predicting survival (11,27,40,41). For instance, during inflammation, the plasma CRP concentration increases, while the PAB concentration decreases.…”