Long-term outcome of dogs recovering from acute kidney injury: 132 cases.

BACKGROUND: Information regarding long-term outcome of dogs recovering from acute kidney injury (AKI) is limited. OBJECTIVES: Determine the long-term outcome of dogs recovering from AKI and identify predictors for serum creatinine concentration (sCr) normalization and long-term outcome. ANIMALS: One hundred thirty-two dogs with AKI that survived ≥30 days postdischarge. METHODS: Retrospective study. Search of medical records of dogs diagnosed with AKI that survived to discharge. Follow-up data were retrieved from medical records and by telephone interviews with the owners or primary care veterinarians or both. RESULTS: Estimated median survival time (MST) was 1322 days (95% confidence interval [CI], 1147-1626), and 76% of the dogs were alive at last contact. Normalization of sCr was documented in 55% of the dogs at discharge and in additional 20% during the follow-up period. The proportion of dogs with sCr normalization decreased with increase in AKI grade (P = .02). Long-term survival was not associated with sCr normalization (P = .63). Etiology was associated with the long-term outcome (P = .004). CONCLUSION AND CLINICAL IMPORTANCE: Long-term survival of dogs with AKI is longer than previously described. Normalization of sCr in 99 dogs (75%) occurred, either at discharge or within the follow-up period. Normalization of sCr was not associated with long-term survival. Estimated MST of dogs with sCr normalization was not different compared with dogs that developed azotemic chronic kidney disease (CKD), presumably because of slow CKD progression rate. Etiology is an important factor determining sCr normalization and long-term survival, emphasizing the importance of the reversibility of renal injury rather than its severity.

Acute kidney injury in dogs: Etiology, clinical and clinicopathologic findings, prognostic markers, and outcome.

BACKGROUND: Acute kidney injury (AKI) is a common, potentially fatal condition. OBJECTIVES: To characterize the etiologies, clinical and clinicopathologic findings, hospitalization period, and outcome of dogs with AKI and to identify markers of negative prognosis. ANIMALS: Two hundred forty-nine client-own dogs diagnosed with AKI and hospitalized at a veterinary teaching hospital. METHODS: Retrospective study. Search of medical records for dogs with AKI. RESULTS: Common clinical signs included lethargy (225/249, 90%), anorexia (206/249, 83%), and vomiting (168/249, 68%). Etiologies included ischemic/inflammatory (144/249, 58%), infectious (19/249, 8%), nephrotoxicosis (14/249, 6%), or other (13/249, 5%). Hospital-acquired AKI was diagnosed in 9% (23/249) of the dogs. Median presentation and peak serum creatinine (sCr) concentrations were 4 mg/dL (range, 1.1-37.9) and 4.6 mg/dL (range, 1.1-43.1), respectively. Dogs were classified to AKI grades as follows: Grade I, 6 (2%), Grade II, 38 (15%), Grade III, 89 (36%), Grade IV, 77 (31%), and Grade V, 39 (16%). One hundred and sixty-four (66%) dogs survived. There was a positive association between death and AKI grade (P = .009). The case fatality rate was higher among dogs with anuria compared with dogs without anuria (50% vs 28%, respectively; odds ratio [95% confidence interval]: 2.5 [1.39-4.6]; P = .002). Forty-seven (18.8%) dogs underwent hemodialysis, of which 60% survived. CONCLUSION AND CLINICAL IMPORTANCE: Two-thirds of dogs with AKI survived. Hospital-acquired AKI was common. The severity of AKI, as reflected by presence of anuria, AKI grade, and other body organs involvement, was associated with the outcome.