Peer-reviewed veterinary case report
How ACE inhibitor treatment affects survival in dogs with proteinuria
By Fulton, Emily A et al.·Published in Journal of veterinary internal medicine·2023·The University of Glasgow Small Animal Hospital, United Kingdom·View original on PubMed →
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Original publication title: Response and survival of dogs with proteinuria (UPC > 2.0) treated with angiotensin converting enzyme inhibitors.
- Species:
- dog
Plain-English summary
An 8-year-old mixed-breed dog was diagnosed with proteinuria, which means there was an abnormal amount of protein in its urine. The dog was treated with an angiotensin-converting enzyme inhibitor (ACEi), a common medication for this condition. About 41% of dogs in a study responded well to this treatment, showing a significant reduction in protein levels within three months. Those that responded had a much better chance of living longer, with many surviving beyond a year compared to those who did not respond. This suggests that if your dog has proteinuria, ACEi treatment could improve their health and longevity.
People also search for: dog proteinuria treatment · ACE inhibitor for dogs · dog kidney disease survival rate
Abstract
BACKGROUND: Angiotensin-converting enzyme inhibitors (ACEi) are a recommended treatment for glomerular proteinuria. Frequency of response to ACEi and the association of achieving proposed urine protein-to-creatinine ratio (UPC) targets on survival is unknown. OBJECTIVES: To determine response rates to ACEi therapy and whether a positive response is associated with improved survival. ANIMALS: Eighty-five dogs with proteinuria (UPC > 2.0). METHODS: Retrospective study including dogs (UPC > 2.0) prescribed an ACEi for treatment of proteinuria. Baseline creatinine, albumin, cholesterol, UPC, and systolic blood pressure were recorded, and cases reviewed to track UPC. Treatment response was defined as achieving a UPC of <0.5 or reduction of ≥50% from baseline within 3 months. Outcome data were collected to determine overall and 12-month survival. RESULTS: Thirty-five (41%) dogs responded to ACEi treatment. Treatment response was statistically associated with both median survival time (664 days [95% confidence interval (CI): 459-869] for responders compared to 177 [95% CI: 131-223] for non-responders) and 12-month survival (79% responders alive compared to 28% non-responders). Baseline azotemia or hypoalbuminemia were also associated with a worse prognosis, with odds ratios of death at 12 months of 5.34 (CI: 1.85-17.32) and 4.51 (CI: 1.66-13.14), respectively. In the 25 dogs with normal baseline creatinine and albumin, response to treatment was associated with 12-month survival (92% responders alive compared to 54% non-responders, P = .04). CONCLUSIONS AND CLINICAL IMPORTANCE: When the UPC is >2.0, achieving recommended UPC targets within 3 months appears to be associated with a significant survival benefit. Response to treatment is still associated with survival benefit in dogs with less severe disease (no azotemia or hypoalbuminemia).
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Search related cases →Original publication on PubMed: https://pubmed.ncbi.nlm.nih.gov/37815154/