Abstract

BackgroundSystemic hypertension (SH) is a potential complication of acute kidney injury (AKI) in dogs.ObjectiveTo describe the prevalence of SH and hypertensive retinopathy in dogs with AKI, to investigate the relationship between SH and severity of AKI and to assess possible factors associated with SH.AnimalsFifty‐two dogs with AKI.MethodsProspective observational study of dogs presenting to a tertiary referral center that fulfilled the International Renal Interest Society (IRIS) guidelines for the diagnosis of AKI. Systolic blood pressure measurement, urine protein/creatinine ratio (UPCR), urine output, presence of hypertensive retinopathy and fluid overload (FO), survival to discharge and duration of hospitalization were subsequently assessed. The prevalence of SH was calculated and the relationship between SH and recorded factors was examined by nonparametric statistics.ResultsThe prevalence of SH (≥160 mm Hg) on admission or during hospitalization was 75% (39/52) and in 56% (22/39) of cases this was severe (≥180 mm Hg). Sixteen percent (7/43) of dogs had evidence of hypertensive retinopathy and 77% (24/31) dogs had UPCR >0.5. Forty‐two percent (22/52) dogs had FO on admission or during hospitalization. There was no association between SH and IRIS AKI grade, oligo/anuria, survival to discharge, duration of hospitalization or proteinuria. Dogs with FO on presentation were more likely to be hypertensive at admission compared to dogs without FO (P = .02). Dogs that did not survive to discharge were more likely to have FO (P = .007).Conclusions and Clinical ImportanceSystemic hypertension is common in dogs with AKI. Systemic hypertension might be associated with FO, which itself is associated with nonsurvival. Monitoring for SH and FO is therefore warranted in dogs with AKI.

Highlights

  • Acute kidney injury (AKI) is defined as an acute and abrupt decrease in kidney function resulting in abnormal glomerular filtration rate (GFR), tubular function and urine production.[1]

  • This prospective study shows that the prevalence of Systemic hypertension (SH) is high in dogs with community acquired acute kidney injury (AKI) and appears to increase during hospitalization; 54% of dogs were hypertensive on presentation and 43% had severe hypertension

  • There is a clear requirement for frequent blood pressure monitoring of animals hospitalized with AKI

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Summary

Introduction

Acute kidney injury (AKI) is defined as an acute and abrupt decrease in kidney function resulting in abnormal glomerular filtration rate (GFR), tubular function and urine production.[1]. In dogs with CKD, there is a positive correlation between systolic blood pressure (SBP) and degree of proteinuria and both SH and proteinuria are associated with disease progression and reduced survival time.[3,10] The prevalence of SH in CKD in various studies ranges between 9% and 93%.11. Glomerular filtration rate is significantly reduced in hypertensive dogs compared to nonhypertensive dogs.[12] in AKI in cats presence of SH has no effect on survival.[5]. Objective: To describe the prevalence of SH and hypertensive retinopathy in dogs with AKI, to investigate the relationship between SH and severity of AKI and to assess possible factors associated with SH. Urine protein/creatinine ratio (UPCR), urine output, presence of hypertensive retinopathy and fluid overload (FO), survival to discharge and duration of hospitalization were subsequently assessed. Monitoring for SH and FO is warranted in dogs with AKI

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