Determination of Extracellular Fluid Volume in Healthy and Azotemic Cats

Finch, Natalie; Heiene, Reidun; Elliott, Jonathan; Syme, H M; Peters, A. M.

doi:10.1111/jvim.12506

Cited by 5 publications

(4 citation statements)

References 28 publications

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“…Furthermore, a recent study suggested that extracellular fluid volume is not different between non-hyperthyroid cats with and without azotaemic CKD (Finch et al 2015).…”

Section: Discussionmentioning

confidence: 99%

Investigation of the association between serum protein concentrations and concurrent chronic kidney disease in hyperthyroid cats

Williams

Elliott

Syme

et al. 2017

Research in Veterinary Science

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Our objective was to identify if changes in serum protein concentrations occur in hyperthyroidism and to assess their association with the development of azotaemia following treatment. Initially non-azotaemic hyperthyroid cats and healthy older cats were included. Serum concentrations of protein fractions were determined by agarose gel electrophoresis and compared between; hyperthyroid and control cats, initially non-azotaemic hyperthyroid cats which developed azotaemia in a 4month follow up period (masked-azotaemic) and those which remained non-azotaemic, and hyperthyroid cats before and at the time of restoration of euthyroidism. Data are presented as median [25th, 75th percentiles]. Hyperthyroid cats (n=56) had higher serum α globulin concentrations (12.5 [10.9, 13.1] g/L vs. 9.8 [3.0, 11.4] g/L; P<0.001) and lower serum γ globulin concentrations (11.4 [9.1, 13.3] g/L vs. 14.0 [12.4, 16.8] g/L; P=0.001) than control cats (n=26). Following treatment, serum total globulin concentration increased (from 38.6 [35.4, 42.8] g/L to 42.3 [39.0, 45.7] g/L; P<0.001), serum α globulin concentration decreased (from 12.5 [10.9, 13.9] g/L to 11.5 [10.1, 12.6] g/L; P<0.001) and serum γ globulin concentration increased (from 11.4 [9.0, 13.3] g/L to 14.0 [12.4, 16.8] g/L; P<0.001). Serum concentrations of total globulin or globulin fractions were not significantly different between masked-azotaemic and non azotaemic groups. In conclusion, hyperthyroidism is associated with altered serum concentrations of the α and γ globulin fractions, however these changes were not associated with the development of azotaemic chronic kidney disease following treatment.

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“…Furthermore, a recent study suggested that extracellular fluid volume is not different between non-hyperthyroid cats with and without azotaemic CKD (Finch et al 2015).…”

Section: Discussionmentioning

confidence: 99%

Investigation of the association between serum protein concentrations and concurrent chronic kidney disease in hyperthyroid cats

Williams

Elliott

Syme

et al. 2017

Research in Veterinary Science

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“…In contrast to amikacin, iohexol showed a slight but significant increase in V ss after fluid administration ( p = 0.008). Iohexol has previously been used as marker for the assessment of the extracellular fluid (ECF) volume ( Zdolsek et al, 2005 ; Finch et al, 2015 ). The volume of distribution of iohexol is hereby used as an indicator of the ECF volume.…”

Section: Discussionmentioning

confidence: 99%

Unraveling the Contribution of Fluid Therapy to the Development of Augmented Renal Clearance in a Piglet Model

et al. 2021

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Augmented renal clearance (ARC) observed in the critically ill pediatric population has received an increased attention over the last years due to its major impact on the disposition and pharmacokinetics of mainly renally excreted drugs. Apart from an important inflammatory trigger, fluid administration has been suggested to contribute to the development of ARC. Therefore, the primary objective of this study was to evaluate the effect of continuous intravenous fluid administration on renal function using a conventional piglet animal model and to quantify the impact of fluid administration on the pharmacokinetics of renally excreted drugs. At baseline, twenty-four piglets (12 treatment/12 control; 7 weeks old, all ♂) received the marker drugs iohexol (64.7 mg/kg body weight (BW)) and para-aminohippuric acid (10 mg/kg BW) to quantify glomerular filtration rate and effective renal plasma flow, respectively. In addition, the hydrophilic antibiotic amikacin (7.5 mg/kg BW) was administered. Following this baseline measurement, the treatment group received fluid therapy as a constant rate infusion of 0.9% saline at 6 mL/kg/h over 36 h. After 24 h of fluid administration, the marker drugs and amikacin were administered again. When comparing both groups, a significant effect of fluid administration on the total body clearances of iohexol (p = 0.032) and amikacin (p = 0.0014) was observed. Clearances of iohexol and amikacin increased with on average 15 and 14%, although large interindividual variability was observed. This led to decreased systemic exposure to amikacin, which was manifested as decrease in area under the plasma concentration-time curve from time 0 h to infinity from 34,807 to 30,804 ng.h/mL. These results suggest that fluid therapy is a key factor involved in the development of ARC and should be taken into account when administering mainly renally excreted drugs. However, further research is necessary to confirm these results in children.

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“…Based on the law of mass conservation, indicator-dilution techniques fulfill the mass balance principle at steady-state, whereby the total indicator mass following distribution in the fluid compartment will remain the same as the total mass injected into the compartment (80,85). Hence, the volume of a body fluid compartment can be estimated provided that the indicator's concentration following homogenous mixing can be accurately determined (84). Although exogenous indicator-dilution techniques are considered the conventional "gold standard" method for volume determination (17,86), they can result in hypersensitivity reactions and potential errors as a result of indicator extravasation, plasma turbidity, Hb contamination, or controversial back-extrapolation methods (18,(87)(88)(89)(90).…”

Section: One-volume Fluid Space Kinetic Modelmentioning

confidence: 99%

“…Although exogenous indicator-dilution techniques are considered the conventional "gold standard" method for volume determination (17,86), they can result in hypersensitivity reactions and potential errors as a result of indicator extravasation, plasma turbidity, Hb contamination, or controversial back-extrapolation methods (18,(87)(88)(89)(90). Radioactive isotopes are cumbersome to use and there is a significant time delay for exogenous indicators to equilibrate to a steady-state distribution (80,84). This precludes the ability to distinguish between the distribution and elimination phases (34,67) and does not permit analysis of acute dynamic fluid shifts (36).…”

Section: One-volume Fluid Space Kinetic Modelmentioning

confidence: 99%

Understanding Volume Kinetics: The Role of Pharmacokinetic Modeling and Analysis in Fluid Therapy

et al. 2020

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Fluid therapy is a rapidly evolving yet imprecise clinical practice based upon broad assumptions, species-to-species extrapolations, obsolete experimental evidence, and individual preferences. Although widely recognized as a mainstay therapy in human and veterinary medicine, fluid therapy is not always benign and can cause significant harm through fluid overload, which increases patient morbidity and mortality. As with other pharmaceutical substances, fluids exert physiological effects when introduced into the body and therefore should be considered as “drugs.” In human medicine, an innovative adaptation of pharmacokinetic analysis for intravenous fluids known as volume kinetics using serial hemoglobin dilution and urine output has been developed, refined, and investigated extensively for over two decades. Intravenous fluids can now be studied like pharmaceutical drugs, leading to improved understanding of their distribution, elimination, volume effect, efficacy, and half-life (duration of effect) under various physiologic conditions, making evidence-based approaches to fluid therapy possible. This review article introduces the basic concepts of volume kinetics, its current use in human and animal research, as well as its potential and limitations as a research tool for fluid therapy research in veterinary medicine. With limited evidence to support our current fluid administration practices in veterinary medicine, a greater understanding of volume kinetics and body water physiology in veterinary species would ideally provide some evidence-based support for safer and more effective intravenous fluid prescriptions in veterinary patients.

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Determination of Extracellular Fluid Volume in Healthy and Azotemic Cats

Cited by 5 publications

References 28 publications

Investigation of the association between serum protein concentrations and concurrent chronic kidney disease in hyperthyroid cats

Investigation of the association between serum protein concentrations and concurrent chronic kidney disease in hyperthyroid cats

Unraveling the Contribution of Fluid Therapy to the Development of Augmented Renal Clearance in a Piglet Model

Understanding Volume Kinetics: The Role of Pharmacokinetic Modeling and Analysis in Fluid Therapy

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