Acute kidney injury in dogs: Etiology, clinical and clinicopathologic findings, prognostic markers, and outcome

Rimer, Dar; Chen, Hilla; Bar‐Nathan, Mali; Segev, Gil

doi:10.1111/jvim.16375

Cited by 19 publications

(41 citation statements)

References 34 publications

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“…Most recently, a retrospective study of 249 dogs found a lower overall mortality rate of 34%, with higher rates of mortality associated with higher grades of AKI (Rimer et al . 2022). Similarly, dogs who died in our study tended to have a higher creatinine than those who survived, although the sample size was too small for statistical analysis.…”

Section: Discussionmentioning

confidence: 99%

“…AKI has previously been associated with high mortality rates and a recent metaanalysis found an overall mortality of 53.1% in cats and 45% in dogs, although infectious aetiologies were associated with a lower mortality rate (Legatti et al 2018). Most recently, a retrospective study of 249 dogs found a lower overall mortality rate of 34%, with higher rates of mortality associated with higher grades of AKI (Rimer et al 2022). Similarly, dogs who died in our study tended to have a higher creatinine than those who survived, although the sample size was too small for statistical analysis.…”

Section: Discussionmentioning

confidence: 99%

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Evaluation of presentation, treatment and outcome in hypertensive emergency in dogs and cats: 15 cases (2003‐2019)

Beeston

Jepson

Cortellini

2022

J of Small Animal Practice

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Hypertensive emergency is well recognised in human medicine, yet there is limited veterinary evidence. This study aimed to determine the presentation, treatment and outcome in dogs and cats with hypertensive emergency. Materials and MethOds:A retrospective case series of dogs and cats with hypertensive emergency identified as follows: acute history with non-invasive Doppler systolic blood pressure greater than 180 mmHg and target organ damage including acute onset seizures, altered mentation with or without lateral recumbency or blindness. Data collected included signalment, history, physical examination and clinicopathological findings, systolic blood pressure, antihypertensive treatment and outcome.results: Seven dogs and eight cats were included presenting with seizures (n=9), blindness (n=4), altered mentation with (n=2) or without (n=2) lateral recumbency. Median age was 9 years (range 1 to 15) and duration of clinical signs before presentation was 1.5 days (range 1 to 15). Median systolic blood pressure on presentation was 230 mmHg (range 190 to 300). Amlodipine was the most common first-line agent (n=10), followed by hydralazine (n=4) and hypertonic saline (n=1). Aetiology of hypertensive emergency was acute kidney injury (n=9), idiopathic hypertension (n=3), hyperthyroidism (n=1), lymphoma (n=1) and suspected cutaneous and renal glomerular vasculopathy (n=1). Five cats and three dogs survived to discharge with an overall survival of 53.3%. clinical significance: Hypertensive emergencies had various presenting signs in this series. AKI was considered to be the cause of hypertension in the majority of patients. Further evaluation of treatment for hypertensive emergencies is warranted, considering almost half of the cases did not survive to discharge.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Evaluation of presentation, treatment and outcome in hypertensive emergency in dogs and cats: 15 cases (2003‐2019)

Beeston

Jepson

Cortellini

2022

J of Small Animal Practice

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“…2,3 Short-term prognosis of AKI is affected by multiple factors including the etiology (which influences the reversibility of the injury), comorbidities, complications, and treatment options. 3,4 In 2 large scale studies of AKI in dogs managed medically or by hemodialysis, short-term mortality rates were 56% (56/99 dogs) and 47% (86/182 dogs), respectively. 2,3 In the former study, 19/43 dogs (44%) that were discharged from the hospital had serum creatinine concentration (sCr) within the reference range during the follow-up period, whereas in the remaining 56% sCr remained above the reference range, and subsequently these dogs were diagnosed with chronic kidney disease (CKD).…”

Section: Introductionmentioning

confidence: 99%

Long‐term outcome of dogs recovering from acute kidney injury: 132 cases

Bar‐Nathan

Chen

Rimer

et al. 2022

Veterinary Internal Medicne

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Background: Information regarding long-term outcome of dogs recovering from acute kidney injury (AKI) is limited.Objectives: Determine the long-term outcome of dogs recovering from AKI and identify predictors for serum creatinine concentration (sCr) normalization and long-term outcome.Animals: One hundred thirty-two dogs with AKI that survived ≥30 days postdischarge.Methods: Retrospective study. Search of medical records of dogs diagnosed with AKI that survived to discharge. Follow-up data were retrieved from medical records and by telephone interviews with the owners or primary care veterinarians or both.Results: Estimated median survival time (MST) was 1322 days (95% confidence interval [CI], 1147-1626), and 76% of the dogs were alive at last contact. Normalization of sCr was documented in 55% of the dogs at discharge and in additional 20% during the follow-up period. The proportion of dogs with sCr normalization decreased with increase in AKI grade (P = .02). Long-term survival was not associated with sCr normalization (P = .63). Etiology was associated with the long-term outcome (P = .004). Conclusion and Clinical Importance:Long-term survival of dogs with AKI is longer than previously described. Normalization of sCr in 99 dogs (75%) occurred, either at discharge or within the follow-up period. Normalization of sCr was not associated with long-term survival. Estimated MST of dogs with sCr normalization was not different compared with dogs that developed azotemic chronic kidney disease (CKD), presumably because of slow CKD progression rate. Etiology is an important factor determining sCr normalization and long-term survival, emphasizing the importance of the reversibility of renal injury rather than its severity.

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“…Acute kidney injury (AKI) results from multiple aetiologies and is associated with mortality as high as 50%–60% in dogs and cats 1–3 . The prevalence of hospital‐acquired AKI is increasing, and AKI is a risk factor for in‐hospital mortality 4 .…”

Section: Introductionmentioning

confidence: 99%

“…Acute kidney injury (AKI) results from multiple aetiologies and is associated with mortality as high as 50%-60% in dogs and cats. [1][2][3] The prevalence of hospital-acquired AKI is increasing, and AKI is a risk factor for in-hospital mortality. 4 The diagnosis of AKI early in its course may improve survival by facilitating prompt, appropriate therapeutic intervention before renal parenchymal lesions become irreversible and severe uraemia ensues.…”

Section: Introductionmentioning

confidence: 99%

Urinary interleukin‐6 is a potentially useful diagnostic and prognostic marker of acute kidney injury in dogs

et al. 2022

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Background Interleukin‐6 (IL6) is a pro‐inflammatory cytokine implicated in the pathophysiology of urinary tract diseases. The objective of this study was to evaluate the diagnostic and prognostic utilities of urinary IL6 (uIL6) in dogs with acute kidney injury (AKI) and other urinary tract diseases. Methods Eighty client‐owned dogs were included and divided into four groups: AKI, chronic kidney disease (CKD), urinary tract infection and healthy controls. Urine samples were analysed for uIL6 and normalised to urinary creatinine (uIL6/uCr). Results Dogs in the AKI group had higher uIL6/uCr compared with the control and CKD groups (p < 0.001 and 0.012, respectively). Receiver operator characteristic (ROC) curve analysis of uIL6/uCr as a diagnostic marker for AKI had an area under the curve (AUC) of 0.91 (95% confidence interval [CI], 0.81–1.0) with 82% sensitivity and 90% specificity (cutoff point 4.5 pg/mg) when including the AKI and control groups. ROC analysis including AKI compared with all other groups had an AUC of 0.77 (95% CI, 0.67–0.87) for the diagnosis of AKI with sensitivity and specificity of 71% and 78%, respectively (cutoff point 10.4 pg/mg). The 30‐day mortality of the AKI group was 34%, and there was no difference in uIL6/uCr between survivors and non‐survivors of AKI. Conclusions uIL6/uCr is a potentially sensitive and specific diagnostic marker for AKI in dogs.

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Acute kidney injury in dogs: Etiology, clinical and clinicopathologic findings, prognostic markers, and outcome

Cited by 19 publications

References 34 publications

Evaluation of presentation, treatment and outcome in hypertensive emergency in dogs and cats: 15 cases (2003‐2019)

Evaluation of presentation, treatment and outcome in hypertensive emergency in dogs and cats: 15 cases (2003‐2019)

Long‐term outcome of dogs recovering from acute kidney injury: 132 cases

Urinary interleukin‐6 is a potentially useful diagnostic and prognostic marker of acute kidney injury in dogs

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