Kidney Disease In Dogs Research Articles

Staging of chronic kidney disease in dogs

Staging of chronic kidney disease in dogs

Symmetry dimethylarginine (SDMA) assay for diagnosis of kidney disease in dogs and cats: a mini review of case reports in Indonesia between 2021-2023

Symmetry Dimethylarginine (SDMA) is an important biomarker for early diagnosis of kidney disease. Studies suggest that SDMA is a more sensitive indicator of kidney function compared to traditional markers such as blood urea nitrogen (BUN) and creatinine. Since 2015, the International Renal Interest Society (IRIS) has established SDMA as one of the indicators for diagnosis and determining the stage of chronic kidney disease (CKD) in dogs and cats. SDMA assay use in veterinary clinics in Indonesia has empirically become more common. The aim of this study was to identify scientific reports on SDMA assay use in the diagnosis of kidney disease in dogs and cats in Indonesia. We performed a literature search in the Garuda portal and Google Scholar using the following keywords: “SDMA” or “Symmetry Dimethylarginine”, “dogs”, “cats” and “Indonesia”. The search strategy utilized English and Bahasa Indonesia, and the results were screened for relevance to the topic, and limited to studies conducted in Indonesia. Seven scientific articles in national and international journals reported the use of SDMA assay in cases of kidney disease in dogs or cats in Indonesia, published between 2021-2023. It is expected that SDMA assay use will continue to increase in veterinary practice settings in the country, and it is therefore critical to have a proper understanding of the advantages and limitations of SDMA use for kidney disease diagnosis.

Effect of Oligo-Fucoidan, Fucoxanthin, and L-Carnitine on Chronic Kidney Disease in Dogs: A Retrospective Study.

Chronic kidney disease (CKD) commonly occurs in old dogs and cats. Oligo-fucoidan, fucoxanthin, and L-carnitine (OFL) compounds have a variety of reno-protective properties, including anti-inflammatory, anti-oxidative, and anti-fibrotic effects. Because their effects have not been investigated in naturally occurring canine CKD, we examined their reno-protective activities in dog patients with CKD. A total of 50 patients (OFL, n = 28; control, n = 22) were included in the analysis. A significant difference was identified in serum blood urea nitrogen and creatinine concentrations between the control and OFL groups at 6 months. No significant difference in electrolytes was found between the groups. A significant difference was identified in serum creatinine concentration between the control and OFL groups in azotemic (CKD IRIS stage 2-4) at 6 months. The OFL compounds showed a reno-protective effect, consistent with previous animal studies. The OFL combination can potentially delay the progression of canine CKD and be used as an adjuvant therapy.

Study on the Effects of Angiotensin Receptor/Neprilysin Inhibitors on Renal Haemodynamics in Healthy Dogs.

An angiotensin receptor/neprilysin inhibitor (ARNI), a heart failure treatment, is a combination drug made up of sacubitril, a neprilysin inhibitor, and valsartan, a vascular receptor blocker. No human or veterinary studies regarding the effect of ARNI on renal haemodynamics in the absence of cardiac or renal issues exist. Therefore, we investigated the effect of ARNI on renal haemodynamics in five healthy dogs. ARNI was administered to all five dogs at an oral dose of 20 mg/kg twice daily for 4 weeks. Renal haemodynamics were assessed on the day before ARNI administration (BL), on Day 7, and on Day 28. The glomerular filtration rate (GFR) significantly increased on Day 28 compared to BL and Day 7, whereas renal plasma flow increased on Day 7 and Day 28 compared to BL. Systolic blood pressure significantly decreased between BL and Day 28. Plasma atrial natriuretic peptide (ANP) concentrations increased on Day 7 compared to BL. Additionally, ANP concentrations increased on Day 28 in three of the five dogs. Different ANP concentrations were observed in the remaining two dogs. Both urine output volume and heart rate remained relatively stable and did not exhibit significant change. In conclusion, ARNI may enhance renal haemodynamics in healthy dogs. ARNI could be a valuable drug for treating both heart and kidney disease in dogs.

Phosphocalcic metabolism and its potential association with biomarkers of kidney disease in dogs with spontaneous hyperadrenocorticism

The pathogenesis of increased serum phosphate concentration and proteinuria in dogs with spontaneous hyperadrenocorticism (HAC) is unclear. A potential link between proteinuria and calcium/phosphate metabolism has never been studied in dogs with HAC. The aims of the study were: (1) To evaluate calcium/phosphate metabolism in dogs with spontaneous HAC and compare to healthy dogs as well as to dogs with non-HAC illness; (2) to look for associations between markers of calcium/phosphate metabolism and biomarkers of kidney disease in dogs with HAC. Fifty-four dogs were included in the study, classified as HAC (n=27), non-HAC disease (n=17), and healthy (n=10). Serum calcium, phosphate, 25(OH)Vitamin D, 1,25(OH)2Vitamin D, plasma intact parathyroid hormone concentration (iPTH), FGF23, and urinary fractional excretion of calcium and phosphate were evaluated in all dogs at diagnosis and compared between each group. The correlation between these variables and urine protein-to-creatinine ratio (UPC) and urinary N-acetylglucosaminidase-to-creatinine ratio (uNAG/C) was evaluated in the HAC group. Medians [range] of serum phosphate concentration, urinary fractional excretion of calcium (FE(Ca)), and iPTH were significantly higher in dogs with HAC than in dogs with non-HAC illness (P<0.01) and healthy dogs (P<0.01). Increased 1,25(OH)2Vitamin D/25(OH)Vitamin D was also observed (P<0.001). In HAC group, UPC was significantly negatively correlated with 25(OH)Vitamin D (r(s): -0.54; P<0.01). Urinary NAG/C was significantly positively correlated with serum phosphate (r(s): 0.46; P=0.019). Increased serum phosphate, urinary excretion of calcium, and hyperparathyroidism were observed in dogs with HAC. Vitamin D metabolism may be shifted towards increased 1-alpha hydroxylation.

Evaluation of Albumin Creatinine Ratio as an Early Urinary Biomarker for Chronic Kidney Disease in Dogs

Evaluation of Albumin Creatinine Ratio as an Early Urinary Biomarker for Chronic Kidney Disease in Dogs

Novel renal injury markers in dogs with ehrlichiosis

Canine monocytic ehrlichiosis (CME) has been observed to impact renal function. Currently, the recognition of acute kidney injury is through the nonspecific biomarker serum creatinine (sCr). Novel markers of renal injury such as urinary clusterin (uClust) and urinary cystatin B (uCysB) may increase our understanding of the relationship between ehrlichiosis and renal cellular injury. The aim of this study was to evaluate novel renal injury biomarkers in dogs with acute CME. Twenty healthy dogs were enrolled in the control group (CG), and 16 dogs naturally infected with Ehrlichia canis were included in the Ehrlichia Group (EG). All dogs were followed for 45 days. EG dogs were treated with doxycycline twice daily for the first 30 days. Urine and serum were collected at: 0, 0.5, 1, 15, 30, and 45 days after start of treatment. Urine concentrations of uClust and uCysB were determined using a research ELISA immunoassay. A linear mixed model was used to estimate population mean of renal injury markers with patient as the random effect, and day and treatment as fixed effects. EG was observed to have higher uClust values compared to CG (estimated population mean EG: 213 ng/dL vs. CG: 84 ng/dL, P &lt; 0.001). EG was observed to have higher uCysB values compared to CG (estimated population mean EG: 248 ng/dL vs. CG: 38 ng/dL, P &lt; 0.001). Increases in uCysB and uClust suggest the presence of renal injury and a possible mechanism for the observed predisposition to chronic kidney disease in dogs with ehrlichiosis.

Clinical features of chronic kidney disease in dogs with the serological presence of Leptospira spp., Ehrlichia canis, and Anaplasma phagocytophilum

Chronic kidney disease is commonly diagnosed in dogs, and clinical signs may be aggravated when infected agents are involved. In this case report, 33 dogs with chronic kidney disease were clinically evaluated and serologically tested for Leptospira spp., Ehrlichia canis, and Anaplasma phagocytophilum. The seroprevalence for Leptospira spp. was 39.4%. The most frequent serovars found were Pyrogenes, Canicola, Bratislava and Australis, with serological titers between 1:100 to 1:800. Clinical signs included fever, depression, decreased body condition, vomiting and hematuria. Significant laboratory findings were anemia, leukocytosis, thrombocytopenia, increased liver enzymes, urea and creatinine, hyperbilirubinemia and hyperphosphatemia. All leptospira seronegative dogs were positive for one or both monitored homoparasites (i.e., E. canis and A. phagocytophilum); only three leptospira seropositive dogs were positive for one or both hemoparasites. Findings also suggest that endemic hemoparasites of dogs should be monitored in dogs with a kidney condition for a better clinical picture of the patients and therapeutic approach.

Evaluation of progression of chronic kidney disease in dogs with myxomatous mitral valve disease.

Cardiovascular and renal diseases are known to affect each other in the cardiovascular renal axis disorder (CvRD). Although CvRD, which includes myxomatous mitral valve disease (MMVD) and chronic kidney disease (CKD), has been described in dogs, there are only a few reports on the progression of CKD in accordance with the severity of MMVD. The aim of this study was to evaluate whether the presence of MMVD is associated with the rate of progression of CKD in dogs. The time from the initial diagnosis to the worsening of the International Renal Interest Society (IRIS) stage and the time for the occurrence of hyperphosphatemia and isosthenuria were evaluated. In this retrospective study, CKD progression was determined as an increase in the IRIS stage by at least one level and the development of hyperphosphatemia or isosthenuria. The CKD progression was compared in dogs with and without comorbid MMVD. Dogs with CKD were divided into two groups: dogs with and without MMVD (n = 63, concurrent group; n = 52, CKD group, respectively). The concurrent group was further divided into two subgroups based on the American College of Veterinary Internal Medicine guidelines (B1 group, n = 24; B2 group, n = 39). The time for progression of CKD from IRIS stage 1 to IRIS stage 2 was significantly shorter in the concurrent group than in the CKD group (log-rank test, p < 0.001). MMVD was associated with an increased risk of progression from stage 1 to stage 2 (hazard ratio, 6.442; 95% confidence interval (CI), 2.354 to 18.850; p < 0.001). The timing of the onset of hyperphosphatemia or isosthenuria in the concurrent group and the CKD group was not significantly different. The results of this study suggest that MMVD could be a risk factor for the progression of CKD. Our findings may help predict the prognosis of dogs with both CKD and MMVD compared to CKD only.

Euglena gracilis como adjuvante no tratamento de um cão com doença renal crônica - relato de caso

ABSTRACT A young dog diagnosed with chronic kidney disease, based on clinical changes and sonographic findings (IRIS, 2023), was supplemented with 15mg per kg of body weight per day of inactive dried Euglena gracilis (henceforth called IDEG) as an adjuvant to standard treatments used for the management of chronic kidney disease in dogs. The treatments were divided into two stages, with a total duration of 120 days. At the end of the treatments, the patient showed improvement in vitality, interaction, weight gain, reduction in azotemia, and a 44% decrease in serum C-reactive protein levels.

Urinary Biomarkers of Kidney Disease in Dogs and Cats.

A variety of urinary markers of the renal disease show promise for the identification of glomerular and tubular damage and monitoring treatment. Most of the markers are currently not widely available, and all could benefit from further study. This review summarizes recent studies on urinary biomarkers of renal disease in dogs and cats.

Osteodistrofia fibrosa decorrente de hiperparatireodismo secundário renal em cão senil

ABSTRACT Renal hyperparathyroidism stands out among the complications of kidney disease in dogs due to phosphorus retention with a predisposition to hypocalcemia, parathyroid hormone stimulation with mobilization of calcium from the bones, characterizing fibrous osteodystrophy, unusual in the elderly. The objective was to report it in 12-year-old Labrador with polyuria, polydipsia, and emesis for five months due to maxillary and mandibular volume increase, followed by loosely fixed teeth, and facial deformity. Blood tests showed anemia, thrombocytosis, azotemia, hypoalbuminemia and hyperphosphatemia and urinalysis showed low density, glycosuria, proteinuria, and moderate caudate and transitional epithelial cells. Oral x-rays showed loss of dental bone support and decreased bone radiopacity. Chest radiographs showed decreased density in the ribs and costochondral junction; on the other hand, organs of the cardiorespiratory system showed no changes. The electrocardiogram and echocardiogram did not show impairment. Abdominal ultrasound revealed kidneys with asymmetry, increased echogenicity of the cortical and poorly preserved cortico-medullary definition. Oral histopathology showed intense fibroplasia associated with bone reabsorption. Support therapy was instituted, but the patient died ten days after consultation. Thus, although uncommon in the elderly, fibrous osteodystrophy should be investigated in dogs with advanced-stage chronic kidney disease and, even with conservative therapies, the prognosis is unfavorable.

Efficacy of domperidone plus renal diet in slowing the progression of chronic kidney disease in dogs with leishmaniosis

BackgroundChronic kidney disease (CKD) represents the main cause of mortality in dogs with leishmaniosis. Domperidone has recently been reported to improve kidney function in leishmaniotic dogs affected by CKD. Serum symmetric dimethylarginine (sSDMA) has also been shown to be a useful biomarker for earlier detection of decreased kidney function when compared to serum creatinine (sCr). This study aimed to assess the efficacy of domperidone plus renal diet in slowing the progression of nephropathy in leishmaniotic dogs with CKD, evaluating sSDMA and sCr as markers of kidney function.MethodsThis study was a therapeutic, prospective, randomized, controlled, 11-month-long field trial. Dogs were recruited if classified as “exposed” to or “infected” with Leishmania infantum and affected by CKD at early stages. After enrolment (T0), dogs were randomized into groups T (treatment) and C (control). All dogs were fed a renal diet and then followed up at 90 (T1), 210 (T2), and 330 (T3) days after inclusion in the study. At T1 and T2, dogs in group T received an oral suspension of domperidone (1 ml/10 kg once a day for up to 28 days).ResultsTwenty-two dogs (i.e., n = 12 in group T and n = 10 in group C) completed the study. At T0, the entire population of enrolled dogs presented a mean sSDMA value of 16.5 ± 3.4 μg/dl. At T1 (i.e., after 3 months of renal diet), sSDMA was significantly decreased in both groups, with an sSDMA of 13.1 ± 4.4 μg/dl for the entire population involved. From T1 to T3, sSDMA gradually increased in group C, while remaining stable in group T, which continued to show a significantly lower value of sSDMA at T3 than at T0. Regarding sCr, at T0 and T1, the mean values of the entire population of dogs were 1.1 ± 0.3 and 1.0 ± 0.4 mg/dl, respectively, with no statistical differences between groups T and C. In group T, sCr decreased significantly from T0 to T1, while returning at T3 to values similar to T0.ConclusionsIn this study, domperidone plus renal diet reduced the progression of kidney disease in leishmaniotic dogs affected by CKD.Graphical

Immune disorders in dogs with chronic kidney disease: Review

The aim of this literature review was to identify the stages of chronic kidney disease in dogs that have greater immune dysfunction and which cellular components of the innate and humoral immune system are most affected by the retention of uremic toxins. Chronic kidney disease is characterized by being a serious and irreversible disease, but common in the practice of medical clinic for dogs and cats and usually affects those of advanced age. The consequences of chronic kidney disease can expand to other systems as the disease progresses; systemic arterial hypertension, hypertensive retinopathies and secondary renal hyperparathyroidism are examples of extra-renal impairment caused by chronic kidney disease. The Interest Renal Society (IRIS), established degrees of progression of renal impairment according to serum concentrations of symmetrical creatinine and dimethylarginine, biomarkers of kidney injury, which allows aid in diagnosis, classification of the degree of nephrological and systemic impairment and treatment affected patient. Studies in human patients demonstrate that, in the terminal stages of kidney disease, there is an impairment of the immune function of these patients, which contributes to the increase in the rate of deaths related to secondary infections, cancers caused by viruses and low responsiveness to vaccines. In Veterinary Medicine, despite the scarcity of research on immunosuppression in dogs with chronic kidney disease, some have observed, in vitro and in vivo environments, dysfunction in the innate and humoral immune system of dogs with advanced chronic kidney disease, due to the proinflammatory environment resulting from the retention of uremic toxins that had their clearance affected by impaired kidney excretory function. Stage III of chronic kidney disease in dogs requires greater care, not only to prevent the disease from progressing to stage IV, but also to prevent immune disorders that may result in death. The adoption of intervention criteria and measures aimed at preventing and / or minimizing these immunological disorders depends on the expansion of research on this topic to establish better clinical management for dogs with nephrological disorder.

Diagnosis of polycystic kidney disease in dogs

A test system has been developed for the diagnosis of polycystic kidney disease in dogs, including primers, probes, and a stub oligonucleotide for another allele. A solution of a control plasmid with a wild-type gene fragment, with a fragment of the mutant allele of the gene, or a mixture of both, imitating a heterozygote, was used as a template. The system is based on the TaqMan method. This test system allows for early diagnosis of animals with mutant alleles in order to monitor the state of health during ontogenesis, as well as exclude these dogs from breeding before their puberty.

Coagulation profile in two nephropathic dogs

Coagulatory abnormalities are common in renal dysfunction in humans. The studies on coagulatory abnormalities in renal failure in dogs are limited. The present paper deals with coagulation profile in acute and chronic kidney disease in dogs. The haemostatic defects observed in acute renal dysfunction included thrombocytopaenia, prolonged capillary bleeding time (CBT), elevated D-Dimer and hypoantithrombinemia which indicated a hypercoagulable state. Prolongation of prothrombin time (PT), activated partial thromboplastin time (aPTT), elevated D-Dimer concentration and hypoantithrombinemia in chronic kidney disease indicated the presence of hypocoagulable state

Clinico-Biochemical findings associated with stage III and stage IV of Chronic Kidney Disease in dogs

The present study on Chronic Kidney Disease (CKD) in dogs was aimed to record the incidence, risk factors, and clinical findings. Dogs irrespective of age, breed, sex with history, and clinical manifestations suggestive of CKD were selected and subjected to physical examination, urinalysis, hematology, and serum biochemistry. Based on these parameters twenty-nine dogs were identified as suffering from CKD and were classified into stage I, stage II, stage III, and stage IV as per the International Renal Interest Society (IRIS) staging system for CKD. Serum biochemistry revealed a significant increase in levels of serum creatinine, BUN, and cholesterol when compared to healthy controls. In conclusion, the prevalence of CKD in dogs was 2.5% and the article discussed the clinical and hemato-biochemical changes in CKD.

Cystatin C and Neutrophil Gelatinase-Associated Lipocalin as Early Biomarkers for Chronic Kidney Disease in Dogs

Early diagnosis of chronic kidney disease (CKD) could facilitate timely and appropriate monitoring and therapy. Traditional biomarkers have limitations. Thus, new biomarkers are needed. The objective of the present study was to compare renal biomarkers (including symmetric dimethylarginine [SDMA], cystatin C [CysC], and urine neutrophil gelatinase-associated lipocalin [NGAL]-creatinine ration [UNCR]) and creatinine (CREA) for early detection of CKD in dogs. Nine healthy dogs and 32 dogs with CKD were included in this study. All dogs underwent physical examination, blood analysis (included CREA and SDMA), urinalysis, and imaging examinations. CysC and NGAL levels were measured in serum and urine, respectively. SDMA, CysC, and UNCR were significantly elevated in dogs with CKD and IRIS stage Ι (P < .0001) than in controls. CysC demonstrated a strong correlation with CREA (r2 = 0.6556, P < .0001). CysC (sensitivity 93.55%, specificity 100%) had the highest sensitivity for detecting CKD, followed by UNCR (sensitivity 90%, specificity 100%), SDMA (sensitivity 84.37%, specificity 100%), and CREA (sensitivity 43.75%, specificity 100%). Additionally, CysC and UNCR (sensitivity 88.89%, specificity 100%) exhibited higher sensitivity and specificity than CREA (sensitivity 88.89%, specificity 66.67%) and SDMA (sensitivity 88.89%, specificity 88.89%) in dogs with CKD International Renal Interest Society (IRIS) stage Ι. CysC as a marker of glomerular filtration rate (GFR) and urinary NGAL as a marker of tubular damage could be used to detect CKD early in dogs better than CREA and SDMA.

Evaluation of the progression of non-azotemic proteinuric chronic kidney disease in dogs

Proteinuria is a recognized risk factor for progression of canine chronic kidney disease (CKD). However, the prognosis of non-azotemic proteinuric CKD in dogs has been studied only to a limited extent. Moreover, the degree to which proteinuria should be decreased to delay CKD progression remains unknown. The purposes of this study were (1) to identify factors associated with disease progression and (2) to investigate the degree of proteinuria, albuminuria, and blood pressure during the course of treatment associated with the progression using time-averaged urine protein:creatinine ratio (UPC) and urine albumin:creatinine ratio (UAC) in canine non-azotemic proteinuric CKD. Twenty-one dogs with non-azotemic proteinuric CKD were included in the study. High UPC and UAC were associated with CKD progression (P < .05). Time-averaged high UPC and UAC were significantly related to progression (P < .05). The cutoff values of these time-averaged parameters for predicting the progression were 4.1 and 2.0, respectively. In dogs with non-azotemic proteinuric CKD, more severe proteinuria and albuminuria were associated with progression. The present study suggests that because UPC ≥ 4.1 and UAC ≥ 2.0 during treatment were associated with a faster progression of non-azotemic proteinuric CKD, therapeutic intervention is warranted.

Applicability of B-mode ultrasonography, ARFI elastography and contrast-enhanced ultrasound in the evaluation of chronic kidney disease in dogs

ABSTRACT: The objective of this study was to verify the applicability of B-mode ultrasonography, ARFI elastography and CEUS in the diagnosis of chronic kidney disease and its Stages in dogs. 24 healthy dogs and 28 with CKD were included. In B-mode, the echogenicity, echotexture and cortico-medullary ratio of the kidneys were verified. By elastography, the shear-wave velocity of the cortical (SWVcort) and medullary (SWVmed) regions were determined and tissue deformity was evaluated. Wash-in, wash-out and peak enhancement (TPic) of the contrast in the renal parenchyma were calculated and homogeneity, presence of filling gaps and distinction of filling phases were evaluated by CEUS. Changes in echogenicity, echotexture and cortico-medullary ratio were observed only in sick patients. There was an increase in SWVcort in CKD, with a cutoff point &gt;2.91m/s. Healthy kidneys were non-deformable and 25% had changes in gray scales. There was an increase in wash-in and TPic, changes in filling characteristics, filling failures and difficulty in distinguishing between the Stages in CEUS in CKD. It was found that dogs with CKD 2, 3 and 4 had greater SWVcort and wash-in values than CKD 1. Elastographic and CEUS changes were observed in dogs with CKD, demonstrating the applicability of ultrasonographic techniques in their diagnosis.