Peer-reviewed veterinary case report
Risk factors for kidney problems after ACE inhibitor treatment in dogs
By Lee, Yelim et al.·Published in Journal of veterinary internal medicine·2025·College of Veterinary Medicine, South Korea·View original on PubMed →
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Original publication title: Retrospective evaluation of risk factors for worsening renal function after angiotensin-converting enzyme inhibitor treatment in dogs.
- Species:
- dog
Plain-English summary
A group of 156 dogs receiving angiotensin-converting enzyme inhibitors (ACEi) for heart issues or high blood pressure were monitored for worsening kidney function. After treatment, 17% of the dogs showed some degree of kidney function decline, with most cases being mild. The study found that dogs taking furosemide (a diuretic) or those with existing kidney problems were at a higher risk for this issue. If your dog is on ACEi and also takes furosemide or has kidney concerns, it's important to have their kidney function checked regularly after starting treatment.
People also search for: dog kidney function after ACEi · furosemide and kidney problems in dogs · ACE inhibitor side effects in dogs
Abstract
BACKGROUND: Angiotensin-converting enzyme inhibitors (ACEi) have the potential to cause worsening renal function (WRF). Therefore, reevaluation of renal function is recommended 1-2 weeks after starting ACEi therapy. OBJECTIVES: To identify risk factors for WRF in dogs receiving ACEi for cardiac diseases, proteinuria, or systemic hypertension. ANIMALS: A total of 156 client-owned dogs that received ACEi were included. METHODS: Serum creatinine concentration was determined at the initial presentation and first reevaluation to detect and grade WRF (increase in sCr ≥ 0.3 mg/dL). Grade 1 (nonazotemic), 2 (mild), and 3 (moderate to severe) WRF were characterized by sCr remaining ≤1.6 mg/dL, 1.7-2.5 mg/dL increase, and 2.6-5.0 mg/dL increase, respectively. Demographic and serum chemistry data, such as total protein, albumin, blood urea nitrogen, creatinine, symmetric dimethylarginine, glucose, triglyceride, total cholesterol concentrations, and serum electrolyte concentrations at first presentation, were evaluated. Multivariable modeling was performed to identify risk factors for WRF after treatment with ACEi. RESULTS: Worsening renal function was identified in 27/156 (17%, 95% confidence interval [CI], 0.11-0.23) dogs after ACEi treatment. It was classified as Grades 1, 2, and 3 in 17, 2, and 8 dogs, respectively. The only significant factors associated with WRF in dogs receiving ACEi were concurrent administration of furosemide (odds ratio, 5.05; 95% CI, 2.05-12.4; P < .001) and pre-existing azotemia (odds ratio, 3.21; 95% CI, 1.28-8.03; P = .01). CONCLUSIONS AND CLINICAL IMPORTANCE: Although WRF is uncommon and mild, ACEi should be cautiously prescribed in dogs receiving furosemide or those with pre-existing azotemia.
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Search related cases →Original publication on PubMed: https://pubmed.ncbi.nlm.nih.gov/39564763/