PubAg

Main content area

Fractional excretion of electrolytes in volume‐responsive and intrinsic acute kidney injury in dogs: Diagnostic and prognostic implications

Author:
Troìa, Roberta, Gruarin, Marta, Grisetti, Chiara, Serafini, Federica, Magna, Luca, Monari, Erika, Giunti, Massimo, Dondi, Francesco
Source:
Journal of veterinary internal medicine 2018 v.32 no.4 pp. 1372-1382
ISSN:
0891-6640
Subject:
death, dogs, electrolytes, excretion, guidelines, kidneys, mortality, prospective studies, regression analysis, risk factors, sodium
Abstract:
BACKGROUND: The value of fractional excretion (FE) of electrolytes to characterize and prognosticate acute kidney injury (AKI) is poorly documented in dogs. OBJECTIVES: To evaluate the diagnostic and prognostic roles of FE of electrolytes in dogs with AKI. ANIMALS: Dogs (n = 135) with AKI treated with standard care (February 2014‐December 2016). METHODS: Prospective study. Clinical and laboratory variables including FE of electrolytes, were measured upon admission. Dogs were graded according to the AKI‐IRIS guidelines and grouped according to AKI features (volume‐responsive, VR‐AKI; intrinsic, I‐AKI) and outcome (survivors/non‐survivors). Group comparison and regression analyses with hazard ratios (HR) evaluation for I‐AKI and mortality were performed. P < .05 was considered significant. RESULTS: Fifty‐two of 135 (39%) dogs had VR‐AKI, 69/135 (51%) I‐AKI and 14/135 (10%) were unclassified. I‐AKI dogs had significantly higher FE of electrolytes, for example, FE of sodium (FENa, %) 2.39 (range 0.04‐75.81) than VR‐AKI ones 0.24 (range 0.01‐2.21; P < .001). Overall, case fatality was 41% (55/135). Increased FE of electrolytes were detected in nonsurvivors, for example, FENa 1.60 (range 0.03‐75.81) compared with survivors 0.60 (range 0.01‐50.45; P = .004). Several risk factors for death were identified, including AKI‐IRIS grade (HR = 1.39, P = .002), FE of electrolytes, for example, FENa (HR = 1.03, P < .001), and urinary output (HR = 5.06, P < .001). CONCLUSIONS AND CLINICAL IMPORTANCE: Fractional excretion of electrolytes performed well in the early differentiation between VR‐AKI and I‐AKI, were related to outcome, and could be useful tools to manage AKI dogs in clinical practice.
Agid:
6067604