Subject(s)
Dog Diseases , Kidney Diseases , Leishmania infantum , Leishmaniasis, Visceral , Leishmaniasis , Animals , Dog Diseases/diagnosis , Dog Diseases/therapy , Dogs , Kidney Diseases/veterinary , Leishmaniasis/drug therapy , Leishmaniasis/veterinary , Leishmaniasis, Visceral/diagnosis , Leishmaniasis, Visceral/drug therapy , Leishmaniasis, Visceral/veterinarySubject(s)
Dog Diseases , Kidney Diseases , Leishmania infantum , Leishmaniasis, Visceral , Leishmaniasis , Animals , Dog Diseases/diagnosis , Dog Diseases/therapy , Dogs , Kidney Diseases/veterinary , Leishmaniasis/drug therapy , Leishmaniasis/veterinary , Leishmaniasis, Visceral/diagnosis , Leishmaniasis, Visceral/drug therapy , Leishmaniasis, Visceral/veterinaryABSTRACT
BACKGROUND: Angiotensin-converting enzyme inhibitors (ACEIs) are currently used to control proteinuria in dogs with chronic kidney disease. Renal diets (RDs) have beneficial effects in the management of azotemic dogs, but its role in proteinuric non-azotemic (PNAz) dogs has been poorly documented. HYPOTHESIS: Administration of a RD to PNAz dogs treated with benazepril (Be) improves proteinuria control compared with the administration of a maintenance diet (MD). ANIMALS: Twenty-two PNAz (urine protein/creatinine ratio [UPC] >1) dogs. METHODS: Randomized open label clinical trial design. Dogs were assigned to group-MD (5.5 g protein/100 kcal ME)/Be or to group-RD (3.7 g protein/100 kcal ME)/Be group during 60 days. Dogs with serum albumin (Alb) <2 g/dL received aspirin (1 mg/kg/12 hours). A physical examination, systolic blood pressure (SBP) measurement, complete blood count (CBC), biochemistry panel, urinalysis, and UPC were performed at day 0 (D0) and day 60 (D60). RESULTS: At D0, there were no significant differences between groups in the evaluated variables. During the study, logUPC (geometric mean (95% CI) and SBP (mean±SD mmHg) significantly decreased (paired t-test, P = 0.001) in Group-RD (logUPC(D0) = 3.16[1.9-5.25]; UPC(D60) = 1.20 [0.59-2.45]; SBP(D0) = 160 ± 17.2; SBP(D60) = 151 ± 15.8), but not in Group-MD (UPC(D0) = 3.63[2.69-4.9]; UPC(D60) = 2.14 [0.76-6.17]; SBP(D0) = 158 ± 14.7; SBP(D60) = 153 ± 11.5). However, RM-ANOVA test did not confirm that changes were consequence of dietary modification. Weight and Alb concentration did not change significantly in any group. CONCLUSION AND CLINICAL RELEVANCE: The administration of a RD to PNAz dogs treated with Be might help to control proteinuria and SBP compared with the administration of a MD, without inducing clinically detectable malnutrition, but more studies are warranted.
Subject(s)
Angiotensin-Converting Enzyme Inhibitors/therapeutic use , Benzazepines/therapeutic use , Dog Diseases/pathology , Proteinuria/veterinary , Renal Insufficiency, Chronic/veterinary , Animals , Blood Cell Count/veterinary , Blood Chemical Analysis/veterinary , Blood Pressure , Creatinine/urine , Dog Diseases/drug therapy , Dogs , Proteinuria/diet therapy , Renal Insufficiency, Chronic/drug therapy , Renal Insufficiency, Chronic/pathology , Serum Albumin/analysis , Urinalysis/veterinaryABSTRACT
BACKGROUND: Studies in dogs with experimental chronic kidney disease (CKD) have demonstrated that abnormalities of calcium-phosphorus (Ca-P) homeostasis occur frequently and have a negative effect on kidney function and survival. However, the prevalence of these alterations in dogs with naturally occurring CKD at different stages of severity has not yet been investigated. HYPOTHESIS: Abnormalities of Ca-P metabolism occur early in the course of CKD with an increased prevalence in more severe stages. ANIMALS: Fifty-four dogs with CKD and 22 healthy dogs. METHODS: Blood and urine samples were obtained for a CBC, biochemistry, determination of parathyroid hormone (PTH), calcitriol, and ionized calcium concentrations and urinalysis. Based on urine protein/creatinine ratio and serum creatinine concentration, dogs were grouped according to the IRIS classification for CKD. RESULTS: Hyperparathyroidism (HPTH) (PTH > or = 48 pg/mL) was diagnosed in 41 (75.9%) dogs with CKD. Its prevalence increased from 36.4% (stage 1) to 100% (stage 4). Hyperphosphatemia (P > 5.5 mg/dL) was present in 37 (68.5%) dogs; increasing in prevalence from 18% (stage 1) to 100% (stage 4). Receiver-operating characteristic curve analysis showed that serum phosphorus concentration in the 4.5-5.5 mg/dL range correctly identified the presence of HPTH in most dogs. Calcitriol concentration progressively decreased in dogs with CKD and differences became statistically significant by stage 3. CONCLUSION AND CLINICAL RELEVANCE: HPTH and hyperphosphatemia occur frequently in dogs with naturally occurring CKD, even at early stages of CKD in some dogs. These findings highlight the importance of monitoring these parameters early in the course of CKD.
Subject(s)
Calcium/metabolism , Dog Diseases/metabolism , Kidney Failure, Chronic/veterinary , Phosphorus/metabolism , Animals , Dogs , Female , Homeostasis , Hyperparathyroidism/diagnosis , Hyperparathyroidism/veterinary , Kidney Failure, Chronic/classification , Kidney Failure, Chronic/metabolism , MaleABSTRACT
Serum phosphorus concentrations were measured in 155 dogs with leishmaniosis at different stages of chronic kidney disease (CKD), and in 54 healthy dogs. CKD was classified into six stages, as follows: stage 0 (dogs with no evidence of CKD), serum creatinine (SCr) less than 125 micromol/l and urine protein:creatinine ratio (UPC) less than 0.2; stage 1A, SCr less than 125 micromol/l and UPC 0.2 to 0.5; stage 1B, SCr less than 125 micromol/l and UPC over 0.5; stage 2, SCr 125 micromol/l to 180 micromol/l; stage 3, SCr 181 micromol/l to 440 micromol/l; stage 4, SCr over 440 micromol/l. The dogs' serum phosphorus concentrations correlated significantly with the severity of CKD (P<0.001), and hyperphosphataemia (>1.8 mmol/l) affected 12 per cent, 11.8 per cent, 50 per cent, 76.9 per cent and 100 per cent of the dogs at stages 1A, 1B, 2, 3 and 4, respectively.
Subject(s)
Dog Diseases/blood , Kidney Failure, Chronic/veterinary , Leishmaniasis/veterinary , Phosphorus/blood , Animals , Dogs , Female , Glomerular Filtration Rate , Kidney Failure, Chronic/blood , Kidney Failure, Chronic/classification , Kidney Failure, Chronic/complications , Leishmaniasis/blood , Leishmaniasis/complications , Male , Retrospective StudiesABSTRACT
BACKGROUND: Glomerular filtration rate (GFR) measurement is an indicator of kidney function. However, its usefulness in dogs at early stages of spontaneous chronic kidney disease (CKD) of glomerular origin, where routine laboratory techniques are not sufficiently sensitive, remains unproved. HYPOTHESIS: That GFR is reduced in proteinuric nonazotemic or mildly azotemic dogs with CKD secondary to leishmaniasis. ANIMALS: Twenty-six dogs with CKD secondary to leishmaniasis and 10 healthy dogs (control group). METHODS: CBC, serum biochemistry, and urinalysis (microalbuminuria and urine protein/creatinine ratio [UPC]) were performed in all dogs. GFR was calculated by measuring exogenous creatinine clearance. Based on degree of proteinuria and serum creatinine concentration (SCr), dogs were classified as group A (control; n = 10): UPC < 0.2, SCr < 1.4 mg/dL; group B (n = 8): UPC, 0.2-0.5, SCr < 1.4 mg/dL; group C (n = 10): UPC > 0.5, SCr < 1.4 mg/dL; group D (n = 5): SCr, 1.4-2 mg/dL; group E (n = 3): SCr > 2 mg/dL. RESULTS: GFR (mL/kg/min) was 3.9 +/- 0.29, 4.4 +/- 0.74, 4.5 +/- 1.44, 2.8 +/- 0.97, and 1.5 +/- 0.43 for groups A, B, C, D, and E, respectively. Eleven dogs (1 from group B, 3 from group C, 4 from group D, and all 3 dogs from group E) had an abnormally low GFR. Four dogs from group B and 5 dogs from group C had a GFR above the upper reference range (>4.5 mL/min/kg). CONCLUSION AND CLINICAL RELEVANCE: Some proteinuric nonazotemic or mildly azotemic dogs with leishmaniasis have low GFR, but glomerular hyperfiltration occurs in other dogs.
