Immune disorders in dogs with chronic kidney disease: Review

Abstract

The aim of this literature review was to identify the stages of chronic kidney disease in dogs that have greater immune dysfunction and which cellular components of the innate and humoral immune system are most affected by the retention of uremic toxins. Chronic kidney disease is characterized by being a serious and irreversible disease, but common in the practice of medical clinic for dogs and cats and usually affects those of advanced age. The consequences of chronic kidney disease can expand to other systems as the disease progresses; systemic arterial hypertension, hypertensive retinopathies and secondary renal hyperparathyroidism are examples of extra-renal impairment caused by chronic kidney disease. The Interest Renal Society (IRIS), established degrees of progression of renal impairment according to serum concentrations of symmetrical creatinine and dimethylarginine, biomarkers of kidney injury, which allows aid in diagnosis, classification of the degree of nephrological and systemic impairment and treatment affected patient. Studies in human patients demonstrate that, in the terminal stages of kidney disease, there is an impairment of the immune function of these patients, which contributes to the increase in the rate of deaths related to secondary infections, cancers caused by viruses and low responsiveness to vaccines. In Veterinary Medicine, despite the scarcity of research on immunosuppression in dogs with chronic kidney disease, some have observed, in vitro and in vivo environments, dysfunction in the innate and humoral immune system of dogs with advanced chronic kidney disease, due to the proinflammatory environment resulting from the retention of uremic toxins that had their clearance affected by impaired kidney excretory function. Stage III of chronic kidney disease in dogs requires greater care, not only to prevent the disease from progressing to stage IV, but also to prevent immune disorders that may result in death. The adoption of intervention criteria and measures aimed at preventing and / or minimizing these immunological disorders depends on the expansion of research on this topic to establish better clinical management for dogs with nephrological disorder.