Open AccessAcute on chronic kidney disease in dogs: Etiology, clinical and clinicopathologic findings, prognostic markers, and survival
Author(s) -
Dunaevich Asia,
Chen Hilla,
Musseri Danielle,
Kuzi Sharon,
MazakiTovi Michal,
Aroch Itamar,
Segev Gilad
Publication year - 2020
Publication title -
journal of veterinary internal medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.356
H-Index - 103
eISSN - 1939-1676
pISSN - 0891-6640
DOI - 10.1111/jvim.15931
Subject(s) - medicine , etiology , lethargy , creatinine , kidney disease , acute kidney injury , surgery , gastroenterology , dialysis
Abstract Background Chronic kidney disease (CKD) and acute exacerbation of CKD (ACKD) are common in dogs. Objective To characterize the etiology, clinical and laboratory findings, and short‐ and long‐term prognosis of dogs with ACKD. Animals One hundred dogs with ACKD. Methods Medical records of dogs diagnosed with ACKD admitted to a veterinary teaching hospital were retrospectively reviewed. Results The most common clinical signs included anorexia (84%), lethargy (77%), vomiting (55%) and diarrhea (37%). Presumptive etiology included inflammatory causes (30%), pyelonephritis (15%), ischemic causes (7%), other (3%), or unknown (45%). Median hospitalization time was 5 days (range, 2‐29 days) and was significantly longer in survivors (6 days; range, 2‐29 days) compared with nonsurvivors (4 days; range, 2‐20 days; P < .001). Mortality rate was 35%. International Renal Interest Society (IRIS) acute kidney injury (AKI) grade at presentation was associated ( P = .009) with short‐term survival, but presumptive etiology was not ( P = .46). On multivariable analysis; respiratory rate ( P = .01), creatine kinase (CK) activity ( P = .005) and serum creatinine concentration (SCR; P = .04) at presentation were associated with short‐term outcome. Median survival time of dogs discharged was 105 days (95% confidence interval [CI], 25‐184), with 35 and 8 dogs surviving up to 6 and 12 months, respectively. Presumptive etiology ( P = .16) and SCR ( P = .59) at discharge were not predictors of long‐term survival. Conclusion and Clinical Importance Short‐term outcome of dogs with ACKD is comparable to those with AKI but long‐term prognosis is guarded. The IRIS AKI grade at presentation is a prognostic indicator of short‐term outcome.