Use of continuous renal replacement therapy for treatment of dogs and cats with acute or acute‐on‐chronic renal failure: 33 cases (2002–2006)

Abstract

Objective: To describe the indications, clinical features, outcomes and complications associated with use of continuous renal replacement therapy (CRRT) in 17 client‐owned dogs and 16 client‐owned cats with acute or acute‐on‐chronic renal failure refractory to aggressive medical management. Series summary: Twenty‐nine percent of dogs and 44% of cats had evidence of pre‐existing chronic kidney disease (CKD). Median duration of CRRT was 16.3 hours (range 0.3–83.0 hours) in dogs and 11.5 hours (range 1.0–35.5 hours) in cats. Median canine blood urea nitrogen (BUN) improved from 41.0 mmol/L (115.0 mg/dL) to 11.8 mmol/L (33.0 mg/dL) and creatinine from 636.5 mmol/L (7.2 mg/dL) to 274 mmol/L (3.1 mg/dL). Median feline BUN improved from 46.4 mmol/L (130 mg/dL) to 13.9 mmol/L (39.0 mg/dL) and creatinine from 1069.6 mmol/L (12.1 mg/dL) to 291.7 mmol/L (3.3 mg/dL). Metabolic acidosis resolved in 80% of affected dogs and 71% of affected cats. Hyperkalemia resolved in 100% of affected dogs and 88% of affected cats. Complications noted with CRRT included iatrogenic hypokalemia, iatrogenic metabolic alkalosis, clinical hypocalcemia, total hypercalcemia, filter clotting, anemia, hypothermia, and neurologic complications. Forty‐one percent of dogs and 44% of cats survived to discharge. No dogs and only 1 cat developed newly diagnosed CKD. New or unique information provided: CRRT can be a viable option for the management of acute or acute‐on‐chronic renal failure in dogs and cats that are refractory to aggressive medical management. The frequency of complications associated with CRRT in this study warrants further experience with this modality before its widespread use can be recommended.

Lesão Renal Tubular Aguda Em Cães E Gatos: Fisiopatogenia E Diagnóstico Ultrassonográfico

“…Alterações na produção de urina, associadas à alterações no estado metabólico e no balanço hidroeletrolítico, podem levar ao colapso circulatório e danos em outros órgãos e sistemas devido a desidratação, nos casos em que ocorrem poliúria, ou hipervolemia e hipertensão, nos casos de oligúria ou anúria (DIEHL & SESHADRI, 2008).…”

Nafamostat Mesilate is not Appropriate as an Anticoagulant during Continuous Renal Replacement Therapy in Dogs

“…In human medicine, it has been widely used to treat acute renal failure (ARF) in critically ill patients [15,16]. In contrast, in veterinary medicine, CRRT is an emerging modality that has been investigated recently but is utilized in only a few veterinary facilities [2,4,6]. Therefore, information regarding CRRT in veterinary medicine is fairly limited.…”

Evaluation of the Hemodynamic Impact of Continuous Renal Replacement Therapy in Healthy Dogs

“…It will be necessary to adjust the circuit volume especially when CRRT is applied to small dogs. Although the circuit volume employed in this study (113.5 ml) was larger than that in the previous report [7], hypotension was not observed. This was probably because the dogs used in the present study were clinically normal and hemodynamically stable compared to the clini- cal cases.…”

“…In human medicine, continuous renal replacement therapy (CRRT) has become the technique of choice in the treatment of ARF. In contrast, in veterinary medicine, intermittent hemodialysis is the standard extracorporeal therapy for ARF and CRRT is an emerging modality; although it has been recently investigated, animal CRRT is used in only a few veterinary facilities [1,7,14]. Therefore, information regarding CRRT in veterinary medicine is fairly limited.…”

“…In dogs with acute or acute-on-chronic renal failure that received CRRT, 2 of 15 dogs (13.3%) were reported to exhibit hypotension when an extracorporeal circuit volume of 50-107 ml was used [7]. When CRRT is initiated, blood is diverted from the patient to the CRRT unit, and the same amount of priming solution in the extracorporeal circuit then enters the body.…”