Peer-reviewed veterinary case report
Ultrafiltration use and risks in dogs with acute kidney injury
By Kopecny, Lucy et al.·Published in Journal of veterinary internal medicine·2023·Department of Veterinary Medicine and Epidemiology, United States·View original on PubMed →
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Original publication title: Ultrafiltration during intermittent hemodialysis in dogs with acute kidney injury.
- Species:
- dog
Plain-English summary
A group of dogs with acute kidney injury (AKI) underwent intermittent hemodialysis (IHD) to help remove excess fluid. During treatment, some dogs experienced complications related to the fluid removal process, but these were generally manageable and did not lead to any deaths. The study found that dogs with higher fluid removal rates were more likely to have complications, highlighting the importance of careful monitoring during treatment. Overall, ultrafiltration during IHD was considered safe for dogs with AKI when managed properly.
People also search for: dog acute kidney injury treatment · intermittent hemodialysis for dogs · complications of fluid removal in dogs
Abstract
BACKGROUND: Ultrafiltration is performed to alleviate fluid overload in dogs with acute kidney injury (AKI) undergoing intermittent hemodialysis (IHD). OBJECTIVES: To describe prescription patterns for ultrafiltration in dogs receiving IHD for AKI and risk factors for ultrafiltration-related complications. ANIMALS: Seventy-seven dogs undergoing 144 IHD treatments between 2009 and 2019. METHODS: Medical records of dogs receiving IHD for AKI were reviewed. The initial 3 IHD treatments in which ultrafiltration was prescribed were included. Ultrafiltration-related complications were defined as those requiring an intervention such as transient or permanent discontinuation of ultrafiltration. RESULTS: Mean fluid removal rate per treatment was 8.1 ± 4.5 mL/kg/h. Ultrafiltration-related complications occurred in 37/144 (25.7%) of treatments. Hypotension was rare (6/144, 4.2% of treatments). No ultrafiltration-related complications resulted in deaths. The mean prescribed fluid removal rate per treatment was higher in dogs with ultrafiltration-related complications than without (10.8 ± 4.9 mL/kg/h vs 8.8 ± 5.1 mL/kg/h, respectively; P = .03). The mean delivered fluid removal rate per treatment was significantly lower in dogs with UF-related complications compared to those without complications (6.8 ± 4.0 mL/kg/h vs 8.6 ± 4.6 mL/kg/h, respectively; P = .04). Variables associated with ultrafiltration-related complications (P < .05) included central venous oxygen saturation, body temperature before IHD treatment, total extracorporeal circuit volume and BUN at the end of IHD treatment. CONCLUSIONS AND CLINICAL IMPORTANCE: Ultrafiltration during IHD in dogs with AKI is overall safe. Higher prescribed ultrafiltration rates were associated with increased risk of complications. Decrease in central venous oxygen saturation is associated with ultrafiltration-related complications, emphasizing the utility of in-line blood monitoring.
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Search related cases →Original publication on PubMed: https://pubmed.ncbi.nlm.nih.gov/36999277/