Premium
Evaluation of a prognostic scoring system for dogs managed with hemodialysis
Author(s) -
Perondi Francesca,
Lippi Ilaria,
Ceccherini Gianila,
Marchetti Veronica,
Bernicchi Lucrezia,
Guidi Grazia
Publication year - 2018
Publication title -
journal of veterinary emergency and critical care
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.886
H-Index - 47
eISSN - 1476-4431
pISSN - 1479-3261
DOI - 10.1111/vec.12736
Subject(s) - medicine , acute kidney injury , hemodialysis , cohort , acute pancreatitis , dialysis , systemic inflammatory response syndrome , kidney disease , disseminated intravascular coagulation , retrospective cohort study , gastroenterology , sepsis
Objective To investigate prognostic models in a cohort of dogs with acute kidney injury (AKI) and acute on chronic kidney disease (AKI/CKD) managed by hemodialysis. Design Retrospective study from July 2011 to November 2014. Setting University Veterinary Teaching Hospital. Animals Forty dogs with historical, clinical, imaging, and laboratory findings consistent with AKI or AKI/CKD managed with intermittent hemodialysis were included. Interventions Scoring system models previously established by Segev et al for outcome prediction in dogs with AKI were applied to all dogs. Results Models A, B, and C correctly classified outcomes in 68%, 83%, and 85% of cases, respectively. In our cohort Model A showed sensitivity of 58% and specificity of 86%, Model B showed sensitivity of 79% and specificity of 87%, Model C showed sensitivity of 86% and specificity of 84%. The presence of anuria ( P < 0.0002), respiratory complications ( P < 0.0001), disseminated intravascular coagulation (DIC) ( P = 0.0004), grade of AKI ( P = 0.0023), pancreatitis ( P = 0.0001), and systemic inflammatory response syndrome (SIRS) ( P = 0.0001) was significantly higher in nonsurvivors compared with survivors. Conclusions In our cohort of patients, Segev's model C showed the best sensitivity and specificity for predicting prognosis, while model A had lower sensitivity. In our cohort of dialysis patients, the presence of respiratory complications, DIC, SIRS, and pancreatitis at hospitalization, were correlated with a poor prognosis.