Concentrations and kinetics of renal biomarkers in dogs with gastric dilatation-volvulus with and without 24-h intravenous lidocaine.

Abstract

BACKGROUND: Gastric dilatation volvulus (GDV) can lead to organ failure including acute kidney injury (AKI). Due to its cytoprotective, antioxidant and anti-inflammatory effects, lidocaine has a potential to prevent AKI in dogs with GDV. DESIGN AND SETTING: Prospective, observational cohort study in client-owned dogs with GDV. OBJECTIVE: To determine concentrations of renal biomarkers for AKI in dogs with GDV with and without intravenous (IV) lidocaine therapy. METHODS: Thirty-two dogs were randomized to receive either IV lidocaine (2 mg/kg, followed by a lidocaine constant rate infusion at a dose of 50 &#x3bc;g/kg/min over 24 h;= 17) or no lidocaine (= 15). Blood and urine samples were taken at admission () (only blood), during or immediately after surgery (), and 24 () and 48 () h after surgery. Plasma creatinine (pCr), plasma neutrophil gelatinase-associated lipocalin (pNGAL), urinary NGAL (uNGAL), uNGAL to creatinine ratio (UNCR), and urinary gamma-glutamyl transferase to creatinine ratio (uGGT/uCr) were evaluated. Biomarker concentrations were compared between dogs with and without IV lidocaine and the course of each marker was determined in comparison to its admission value. RESULTS: In the entire population, a significantly higher pCr at(median, 95 &#x3bc;mol/L, interquartile range, 82-105) compared with(69 &#x3bc;mol/L, 60-78),(63 &#x3bc;mol/L, 52-78), and(78 &#x3bc;mol/L, 65-87) (< 0.001) was found. Plasma NGAL increased significantly between(5.66 ng/mL, 3.58-7.43) and(7.50 ng/mL, 4.01-11.89) (= 0.006) and(9.86 ng/mL, 5.52-13.92) (< 0.001), respectively. Urinary NGAL increased significantly between(0.61 ng/mL, 0.30-2.59) and(2.62 ng/mL, 1.86-10.92) (= 0.001) and(4.79 ng/mL, 1.96-34.97 (< 0.001), respectively. UNCR increased significantly between(0.15 &#x3bc;g/mmol, 0.09-0.54) and(1.14 &#x3bc;g/mmol, 0.41-3.58) (= 0.0015) and(1.34 &#x3bc;g/mmol, 0.30-7.42) (< 0.001), respectively. Concentrations of uGGT/uCr increased significantly fromhighest at(6.20 U/mmol, 3.90-9.90) and significantly decreased at(3.76 U/mmol, 2.84-6.22) (< 0.001). No significant differences in any renal biomarker concentration were found between dogs with and without IV lidocaine therapy. CONCLUSION AND CLINICAL RELEVANCE: Plasma NGAL, uNGAL and UNCR remained increased up to 48 h post-surgery. No evidence of lidocaine-associated renoprotection was found.