Association Between Exposure to Ehrlichia spp. and Risk of Developing Chronic Kidney Disease in Dogs

Burton, Wade; Drake, Corie; Ogeer, Jennifer; Buch, Jesse; Mack, Rebekah; McCrann, Donald J.; Coyne, Michael J.

doi:10.5326/jaaha-ms-7012

Cited by 15 publications

(11 citation statements)

References 17 publications

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“…Dogs diagnosed with ehrlichiosis are known to have a 112% higher risk of developing CKD compared to animals that do not develop the infection [ 20 ]. Because of that, our results may hypothesize that kidney injuries suffered from subclinical stages may contribute to the chronicity of changes, impacting this type of future repercussion.…”

Section: Discussionmentioning

confidence: 99%

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Glomerulotubular pathology in dogs with subclinical ehrlichiosis

et al. 2021

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Subclinical stage of ehrlichiosis is characterized by absence of clinical or laboratory alterations; however, it could lead to silent glomerular/tubular changes and contribute significantly to renal failure in humans and animals. The aim of this study was to evaluate glomerular and tubular alterations in dogs with subclinical ehrlichiosis. We evaluated renal biopsies of 14 bitches with subclinical ehrlichiosis and 11 control dogs. Samples were obtained from the left kidney, and the tissue obtained was divided for light microscopy, immunofluorescence, and transmission electron microscopy. Abnormalities were identified by light microscopy in 92.9% of dogs with ehrlichiosis, but not in any of the dogs of the control group. Mesangial cell proliferation and synechiae (46.1%) were the most common findings, but focal segmental glomerulosclerosis and ischemic glomeruli (38.4%), focal glomerular mesangial matrix expansion (30.7%), mild to moderate interstitial fibrosis and tubular atrophy (23%), and glomerular basement membrane spikes (23%) were also frequent in dogs with ehrlichiosis. All animals with ehrlichiosis exhibited positive immunofluorescence staining for immunoglobulins. Transmission electron microscopy from dogs with ehrlichiosis revealed slight changes such as sparse surface projections and basement membrane double contour. The subclinical phase of ehrlichiosis poses a higher risk of development of kidney damage due to the deposition of immune complexes.

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Section: Discussionmentioning

confidence: 99%

“…This condition is reinforced by the evidence that dogs infected with Ehrlichia sp . are at increased risk of developing CKD [ 20 ]; however, no renal histopathological analysis has been done to confirm this hypothesis.…”

Section: Introductionmentioning

confidence: 99%

Glomerulotubular pathology in dogs with subclinical ehrlichiosis

et al. 2021

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“…Serological testing for ehrlichiosis detection was not conducted in this dog, so this hypothesis is unproven. A recent retrospective study has indicated a 2.12 relative risk of CKD acquirement in dogs with ehrlichiosis, a 112% greater risk compared to those in the unexposed group (Burton et al 2020).…”

Section: Pathophysiology Of Ckdmentioning

confidence: 99%

IRIS-Stage 4 CKD in a Dog: Diagnostic Approaches and Staging of Chronic Kidney Disease: A Case Study

Gunawan

Amelia

Resyana³

et al. 2023

J Exp Bio & Ag Sci

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Chronic kidney disease (CKD) is a devastating disease of the kidneys that often arise from unresolved acute injury. As a chronic disease, CKD is challenging to diagnose, thus it needs a good combination of a comprehensive understanding of the kidney’s anatomy and physiology and thorough planning for a framework of diagnostic tools to be utilized. This study is intended to provide the diagnostic planning used to determine CKD in an approximately 5-year-old intact male dog that was brought to My Vets Animal Clinic for a check-up visit. On presentation, the dog was emaciated, mildly dehydrated, halitotic, and infested with ticks. A complete blood count (CBC) indicated a normocytic, normochromic, non-regenerative anemia, and lymphopenia. The blood chemistry panel indicated azotemia, elevated symmetric dimethylarginine (SDMA), hypocalcemia, and hyperphosphatemia. Elevated SDMA level (64 μg/dL, reference value: 0-14 μg/dL) and hypercreatinemia (5.9 mg/dL, reference value: 0.5-1.8 mg/dL) indicated impaired glomerular filtration. Physical and clinical pathological findings signified the presence of CKD in this dog, with a stage-4 severity based on International Renal Interest Society (IRIS) CKD staging criteria. The prognosis of this case was highly guarded, and the dog eventually passed away on the sixth day of hospitalization. In a case with an uncertain outcome, accuracy in both diagnosis and staging of CKD in dogs will aid the therapy regimen planning, which may improve the patient’s conditions.

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“…Although it must be emphasized that statistical methods cannot extract bias from data, there are some recent developments in statistics and in the availability of statistical software that might aid in producing more realistic and clinically meaningful estimations of effect in observational studies that move away from the rigid bright‐line decision making that is often associated with traditional null hypothesis statistical testing. For instance, propensity scoring 11 and related statistical methods provide a means by which 2 observational groups can be compared, while allowing for numerous covariates (possible confounders and effect modifiers) to be included in the analysis. This type of analysis aims to reduce bias effects by including the various factors (covariates) that might determine allocation, outcome, or both.…”

Section: Alternatives To Standard Analytical Techniquesmentioning

confidence: 99%

What is the value of statistical testing of observational data?

Jeffery

Budke

2022

Veterinary Surgery

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Statistical analysis of medical data aims to reveal patterns that can aid in decision making for future cases and, hopefully, improve patient outcomes. Large and bias‐free datasets, such as those produced in formal randomized clinical trials, are necessary to make such analyses as reliable as possible. For a host of reasons, randomized trials are, unfortunately, relatively uncommon in veterinary medicine and surgery, implying that less ideal datasets (mostly observational data) must form the basis for much of our decision making regarding treatment of individual patients under our care. In this review, we first describe the common shortcomings of many observational veterinary datasets when viewed in comparison with their optimal counterparts and highlight how the deficiencies can lead to unreliable conclusions. We illustrate how many of the interpretative problems associated with observational data, predominantly various forms of bias, are not solved, and may even be exacerbated, by statistical analysis. We emphasize the need to examine summary data and its derivation in detail without being lured into relying upon P values to draw conclusions and advocate for completely omitting statistical analysis of many observational datasets. Finally, we present some suggestions for alternative statistical methods, such as propensity scoring and Bayesian methods, which might help reduce the risk of drawing unwarranted, and overconfident, conclusions from imperfect data.

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Association Between Exposure to Ehrlichia spp. and Risk of Developing Chronic Kidney Disease in Dogs

Cited by 15 publications

References 17 publications

Glomerulotubular pathology in dogs with subclinical ehrlichiosis

Glomerulotubular pathology in dogs with subclinical ehrlichiosis

IRIS-Stage 4 CKD in a Dog: Diagnostic Approaches and Staging of Chronic Kidney Disease: A Case Study

What is the value of statistical testing of observational data?

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