Nutritional and laboratory parameters affect the survival of dogs with chronic kidney disease

Pedrinelli, Vivian; Lima, Daniel Magalhães; Duarte, Caio Nogueira; Teixeira, Fernando Ribeiro; Porsani, Mariana Yukari Hayasaki; Zarif, Cecilia; Amaral, Andressa Rodrigues; Vendramini, Thiago Henrique Annibale; Kogika, Márcia Mery; Brunetto, Márcio Antônio

doi:10.1371/journal.pone.0234712

Cited by 12 publications

(10 citation statements)

References 16 publications

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“…Among the therapeutic approaches to CKD, it is recommended to provide renal diets for dogs stages 2 and up, and mainly for stage 3, classified based on serum creatinine concentrations according to the International Renal Interest Society (IRIS) [7]. The main objectives for providing a therapeutic renal diet include control of clinical signs, reduction of electrolyte and mineral disturbances, maintenance of body condition score (BCS) and muscle mass score (MMS), and supply of sufficient energy and essential nutrients [8]. Furthermore, previous studies have already demonstrated that the intake of a renal diet correlated to increased survival in dogs with CKD [8,9].…”

Section: Introductionmentioning

confidence: 99%

“…The main objectives for providing a therapeutic renal diet include control of clinical signs, reduction of electrolyte and mineral disturbances, maintenance of body condition score (BCS) and muscle mass score (MMS), and supply of sufficient energy and essential nutrients [8]. Furthermore, previous studies have already demonstrated that the intake of a renal diet correlated to increased survival in dogs with CKD [8,9]. Therapeutic renal diets generally have reduced levels of protein and sodium and restricted levels of phosphorus compared to maintenance diets [10].…”

Section: Introductionmentioning

confidence: 99%

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Evaluation of Serum and Urine Amino Acids in Dogs with Chronic Kidney Disease and Healthy Dogs Fed a Renal Diet

et al. 2021

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This observational study aimed to evaluate serum and urinary amino acid (AA) concentrations in healthy dogs and dogs with chronic kidney disease (CKD) fed a commercial therapeutic renal diet with reduced protein and phosphorus levels. Ten dogs with CKD stages 3 or 4 composed the study group and received the renal diet for 180 days (RG T180). A control group (CG T30) composed of seven healthy dogs was fed a renal diet for 30 days. When comparing serum AA between RG T180 and CG T30, histidine, isoleucine, leucine, lysine, phenylalanine, tryptophan, cysteine, citrulline, ornithine, taurine, branched-chain amino acids (BCAA), and total essential amino acids (EAA) were higher in RG T180. Meanwhile, arginine, asparagine, aspartate, glutamine, serine, and tyrosine were higher in CG T30. Serum phenylalanine, tryptophan, and hydroxyproline were higher in RG T0 (dogs with CKD before consuming a renal diet) when compared to RG T180. In addition, the serum ratios of arginine/citrulline, tyrosine/phenylalanine, and serine/glycine were higher in CG T30 than in RG T180. Concerning urinary AA concentrations in CKD dogs, isoleucine, phenylalanine, tryptophan, aspartate, cysteine, and BCAA were higher in RG T180. In urine, the total EAA/total non-essential AA ratio in RG T180 was higher than in CG T30 as well as tyrosine/phenylalanine ratio higher in CG T30. In conclusion, the combination of renal diet and conservative treatment over 6 months in dogs with CKD stages 3 or 4 affected the AAs metabolism when compared to healthy adult dogs.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Evaluation of Serum and Urine Amino Acids in Dogs with Chronic Kidney Disease and Healthy Dogs Fed a Renal Diet

et al. 2021

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“…Because hyperphosphatemia and the calcium × phosphorous product have been recognized as prognosis factors in dogs with CKD, 6 , 7 , 8 , 9 , 10 , 46 , 47 phosphate restriction is an important treatment. For dogs, a renal diet consists of the restriction of protein, phosphate and salt, and the supplementation of omega‐3 fatty acids.…”

Section: Discussionmentioning

confidence: 99%

“…Therefore, these disorders are considered important complications and are termed CKD—mineral and bone disorder (MBD) 2‐5 . Hyperphosphatemia is known to be a prognostic factor for shorter survival time in dogs with CKD 6‐10 . Therefore, prevention and management of hyperphosphatemia may improve the prognosis of dogs with CKD.…”

Section: Introductionmentioning

confidence: 99%

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Association between serum fibroblast growth factor‐23 concentration and development of hyperphosphatemia in normophosphatemic dogs with chronic kidney disease

Miyakawa

Hsu

Ogawa

et al. 2021

Veterinary Internal Medicne

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Background Fibroblast growth factor (FGF)‐23 is increased first in the sequence of changes associated with chronic kidney disease (CKD)‐mineral and bone disorder. Thus, its measurement may serve as a predictive indicator of incident hyperphosphatemia. Objectives To investigate whether serum FGF‐23 concentration in normophosphatemic dogs with CKD is associated with the risk of the subsequent development of hyperphosphatemia and CKD progression. Animals Forty‐two normophosphatemic dogs with CKD. Methods Blood samples and medical records were retrospectively investigated. Hyperphosphatemia was defined as a serum phosphorous concentration >5.0 mg/dL. Progression was defined as a >1.5‐fold increase in serum creatinine concentration. The time periods and hazard ratios for these outcomes were assessed using Kaplan‐Meier analysis, log‐rank test, and univariate Cox regression analysis. The variables associated with the outcomes in the univariate analysis were included in the multivariate Cox regression model with backward selection. Results Serum FGF‐23 concentration >528 pg/mL was associated with a shorter time to development of hyperphosphatemia ( P < .001) and CKD progression ( P < .001). In multiple Cox regression analysis, increased FGF‐23 concentration remained a significant variable associated with these outcomes ( P < .05). Conclusions and Clinical Importance Increased FGF‐23 concentration in normophosphatemic dogs with CKD was associated with significant risk of development of hyperphosphatemia, independent of CKD stage, and of the progression of CKD. Future research focusing on whether interventions that decrease FGF‐23 secretion will slow the development of hyperphosphatemia and CKD progression is needed.

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Survival of dogs with pituitary‐dependent hyperadrenocorticism treated twice daily with low doses of trilostane

et al. 2022

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Background Twice daily low trilostane doses have proven to be effective to manage canine Cushing's syndrome. However, survival and prognostic factors in dogs treated with this protocol have not been evaluated. The aim of the study was to evaluate survival and prognostic factors, including systolic blood pressure (SBP) at diagnosis, in dogs with pituitary‐dependent hypercortisolism (PDH) treated with low trilostane doses. Methods Medical records of 91 dogs newly diagnosed with PDH initially treated with 0.2–1.1 mg/kg of trilostane twice daily were retrospectively included. Survival times were calculated using the Kaplan–Meier estimator. Univariable and multivariable analysis were performed using the Cox proportional hazard regression analysis. Results Overall, median survival was 998 days (range 26–1832 days, 95% confidence interval = 755–1241 days). In the multivariable analysis, age (hazard ratio [HR] = 1.337, p < 0.001), presence of calcinosis cutis (HR = 5.271, p < 0.001), body condition score (BCS) ≤3/9 (HR = 8.100, p < 0.001) and higher platelet count (HR = 1.002, p = 0.022) were negatively correlated with survival. SBP was not associated with survival. Conclusions Low‐dose trilostane treatment twice daily provides slightly longer survival than previously reported for dogs with PDH treated once or twice daily at higher doses. Older age, presence of calcinosis cutis, low BCS and higher platelet count, but not systemic hypertension, are predictive of poorer prognosis in dogs with PDH.

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Nutritional and laboratory parameters affect the survival of dogs with chronic kidney disease

Cited by 12 publications

References 16 publications

Evaluation of Serum and Urine Amino Acids in Dogs with Chronic Kidney Disease and Healthy Dogs Fed a Renal Diet

Evaluation of Serum and Urine Amino Acids in Dogs with Chronic Kidney Disease and Healthy Dogs Fed a Renal Diet

Association between serum fibroblast growth factor‐23 concentration and development of hyperphosphatemia in normophosphatemic dogs with chronic kidney disease

Survival of dogs with pituitary‐dependent hyperadrenocorticism treated twice daily with low doses of trilostane

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