The prevalence of albuminuria in dogs and cats in an ICU or recovering from anesthesia

Abstract

The prevalence of albuminuria in animals admitted to the ICU or recovering from anesthesia is higher than reported previously and transient in some patients. The presence of albuminuria may be a negative prognostic indicator in this population.

Associations among Albuminuria, C‐Reactive Protein Concentrations, Survival Predictor Index Scores, and Survival in 78 Critically Ill Dogs

“…*Significant using a Bonferroni-adjusted P-value threshold for significance of .0125. disease. [7][8] In 1 study, 8 albuminuria was present in 72% (23/32) and 55% (40/73) of dogs admitted to an intensive care unit for stabilization or postoperative recovery, respectively. Presence of albuminuria was a significant risk factor for mortality in dogs in that study.…”

“…7 The age-dependent increase in urinary albumin concentration complicates establishment of a quantitative definition for microalbuminuria in dogs; currently, a range of 1-30 mg/ dL is used. 7,8 In critically ill human beings, increased untimed single-sample urine albumin concentration (U-ALB) or an increased urine albumin : creatinine ratio (UACR) at time of admission and increasing UACR over the course of hospitalization have been associated with increased morbidity and mortality. 6,[9][10][11][12][13][14] The UACR determined within 15 minutes of admission to the intensive care unit has been found to be as good a predictor of morbidity and mortality (AUC 0.61-0.74) as APACHE2 (AUC 0.72-0.80), simplified acute physiology scores (AUC 5 0.79), and sequential organ failure assessment (SOFA) scores (AUC 0.72) at 24 hours.…”

“…6,10 In 1 recently published study of dogs and cats admitted to an intensive care unit, albuminuria was associated with an increased risk of mortality. 8 Identification of objective biomarkers of disease severity with results that can be reported quickly may allow for better allocation of client and hospital resources and limit the use of expensive and invasive therapeutics to those patients at greatest risk of mortality, potentially leading to improved survival in the critical care setting. The primary objective of our study was to evaluate for associations among SPI2 score, CRP concentration, U-ALB, and UACR, and survival in critically ill dogs.…”

“…Presence of albuminuria was a significant risk factor for mortality in dogs in that study. 8 ROC curve analysis is increasingly being utilized to evaluate the diagnostic accuracy of tests. For an ROC curve, the entire spectrum of possible sensitivities is plotted against the entire range of specificities, expressed as the false positive rate (1-specificity), based on alterations in the diagnostic cut-off for a positive versus negative result.…”

Urinary biomarkers of renal function in dogs and cats: a review

“…Reported causes of increased urinary albumin are summarised in Table 1. In critically ill dogs, microalbuminuria is associated with shorter survival (Vaden et al 2010;Whittemore et al 2011). In cats, microalbuminuria was associated with the presence of underlying disease (e.g.…”