Acute kidney injury raises death risk in dogs with twisted stomach

Abstract

OBJECTIVE: To evaluate the prevalence of acute kidney injury (AKI) in dogs with gastric dilatation and volvulus (GDV), identify risk factors associated with AKI diagnosed at presentation or that developed in hospital, and evaluate the association between AKI and selected nonrenal risk factors and mortality before discharge. METHODS: Medical records of 106 dogs that underwent surgical correction of GDV between January 2013 and September 2023 were retrospectively reviewed. Dogs were categorized as presenting with or developing AKI in hospital, according to International Renal Interest Society criteria. Univariate and multivariate logistic regression were used to evaluate the association between selected risk factors and AKI or mortality. RESULTS: In total, 20 of 106 dogs (18.9%) had AKI, with 18 of 106 dogs (17.0%) presenting with it. Sixteen dogs (15.1%) did not survive to discharge, of which 8 and 9 had AKI on presentation and at any time point, respectively. Dogs with AKI on presentation (OR, 7.90) or at any time point (OR, 9.23) had greater odds of not surviving to discharge. On multivariate analysis, preoperative lactate (OR, 1.13 for every 0.5 mmol/L higher) was significantly associated with presenting with AKI, and lowest mean arterial blood pressure during anesthesia (OR, 0.42 for every 10 mm Hg higher) and hetastarch infusion (OR, 4.00) were significantly associated with mortality. CONCLUSIONS: AKI, lowest mean arterial blood pressure during anesthesia, and hetastarch administration were associated with mortality in dogs with GDV. CLINICAL RELEVANCE: Careful assessment of kidney function is recommended in dogs with GDV, as concurrent AKI is common and associated with outcome.