Peer-reviewed veterinary case report
Acute flare-ups of chronic kidney disease in dogs - signs and outlook
By Dunaevich, Asia et al.·Published in Journal of veterinary internal medicine·2020·Veterinary Teaching Hospital·View original on PubMed →
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Original publication title: Acute on chronic kidney disease in dogs: Etiology, clinical and clinicopathologic findings, prognostic markers, and survival.
- Species:
- dog
Plain-English summary
A group of 100 dogs with acute on chronic kidney disease (ACKD) showed symptoms like loss of appetite, tiredness, vomiting, and diarrhea. The dogs were hospitalized for an average of 5 days, with those that survived staying longer than those that did not. The study found that certain factors, like respiratory rate and blood tests, could help predict short-term survival. While 35% of the dogs passed away during treatment, those that were discharged had a median survival time of about 105 days. Unfortunately, the long-term outlook for these dogs remains uncertain.
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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.
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Search related cases →Original publication on PubMed: https://pubmed.ncbi.nlm.nih.gov/33044036/