How Ultrasound Can Be Useful for Staging Chronic Kidney Disease in Dogs: Ultrasound Findings in 855 Cases.

Francesca Perondi,Ilaria Lippi,Simonetta Citi,Barbara Bruno,Antonio Borrelli,Veronica Marchetti

doi:10.3390/vetsci7040147

Francesca Perondi, Ilaria Lippi + Show 4 more

Open Access

https://doi.org/10.3390/vetsci7040147

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Journal: Veterinary sciences	Publication Date: Oct 1, 2020
Citations: 7	License type: CC BY 4.0

Affiliation: University of Pisa, University of Turin

Abstract

In patients affected by chronic kidney disease (CKD), some ultrasonographic (US) abnormalities have been shown to correlate better than others with the progression of the disease. The aim of the study was to evaluate the prevalence of the most frequent renal US abnormalities in dogs at different stages of CKD, and to investigate their association with CKD International Renal Interest Society (IRIS) stages. Medical records and ultrasonographical report of 855 dogs were retrospectively included. The most frequent renal ultrasonographic abnormalities were: increased cortical echogenicity, abnormal ratio of cortico-medullary junction (C/M) and pyelectasia. A statistically significant difference in the prevalence of irregular contour, abnormal cortico-medullary junction, abnormal C/M, increased cortical echogenicity, and pyelectasia was found for dogs at different IRIS stages. The number of dogs with more than one US abnormality increased significantly with the progression of IRIS stage. In conclusion, increased cortical echogenicity, abnormal C/M junction and pyelectasia were the most prevalent US abnormalities in our CKD population. Although none of the US abnormalities showed a significantly higher prevalence, the number of dogs presenting > 3 US abnormalities increased significantly from IRIS 2 to IRIS 4. Renal US is an excellent ancillary diagnostic test, which should be used together with renal functional parameters, to monitor the progression of CKD.

Highlights

Chronic kidney disease (CKD) is the most commonly recognized renal disease in dogs, and it is defined as any structural and/or functional abnormality of one or both kidneys, which has been continuously present for at least three months [1,2]
Stages of chronic kidney disease (CKD) are based on the evaluation of serum creatinine, symmetric dimethylarginine (SDMA), proteinuria, and blood pressure, in order to facilitate diagnosis, prognostic evaluation, and treatment of the disease [1,3]
For each dog included in the study, data regarding history, physical examination, biochemical profile and US report were collected from the medical record

Summary

Introduction

Chronic kidney disease (CKD) is the most commonly recognized renal disease in dogs, and it is defined as any structural and/or functional abnormality of one or both kidneys, which has been continuously present for at least three months [1,2]. Abdominal ultrasonography (US) is routinely performed and recommended in animals with renal disease, or when creatinine serum levels are increased [4,5,6]. The ultrasound characterization of chronic nephropathy is based on subjective criteria, such as cortical echogenicity, kidney shape, kidney size and internal architecture [4]. Increased cortical echogenicity and decreased corticomedullary differentiation are reported to be the more common signs of CKD in veterinary medicine [4,6]. These changes are suggestive of chronic and irreversible

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