Evaluation of progression of chronic kidney disease in dogs with myxomatous mitral valve disease

Abstract

IntroductionCardiovascular and renal diseases are known to affect each other in the cardiovascular renal axis disorder (CvRD). Although CvRD, which includes myxomatous mitral valve disease (MMVD) and chronic kidney disease (CKD), has been described in dogs, there are only a few reports on the progression of CKD in accordance with the severity of MMVD. The aim of this study was to evaluate whether the presence of MMVD is associated with the rate of progression of CKD in dogs. The time from the initial diagnosis to the worsening of the International Renal Interest Society (IRIS) stage and the time for the occurrence of hyperphosphatemia and isosthenuria were evaluated.Materials and methodsIn this retrospective study, CKD progression was determined as an increase in the IRIS stage by at least one level and the development of hyperphosphatemia or isosthenuria. The CKD progression was compared in dogs with and without comorbid MMVD.ResultsDogs with CKD were divided into two groups: dogs with and without MMVD (n = 63, concurrent group; n = 52, CKD group, respectively). The concurrent group was further divided into two subgroups based on the American College of Veterinary Internal Medicine guidelines (B1 group, n = 24; B2 group, n = 39). The time for progression of CKD from IRIS stage 1 to IRIS stage 2 was significantly shorter in the concurrent group than in the CKD group (log-rank test, p < 0.001). MMVD was associated with an increased risk of progression from stage 1 to stage 2 (hazard ratio, 6.442; 95% confidence interval (CI), 2.354 to 18.850; p < 0.001). The timing of the onset of hyperphosphatemia or isosthenuria in the concurrent group and the CKD group was not significantly different.ConclusionThe results of this study suggest that MMVD could be a risk factor for the progression of CKD. Our findings may help predict the prognosis of dogs with both CKD and MMVD compared to CKD only.

A Pilot Study of the Role of Selected Biomarkers of Kidney Injury in Dogs with Dilated Cardiomyopathy

“…Echocardiography was conducted using an ESAOTE MY LAB 40 eHD device with a 1.0-4.0 MHz phased array transducer. Breed-specific criteria were applied when appropriate [22,[38][39][40][41][42][43][44]. The examination followed existing guidelines and was performed on an echocardiographic table in right and left lateral recumbency.…”

“…The echocardiographic assessment employed a conventional protocol encompassing 2-D, M-mode, spectral Doppler, and color Doppler techniques. This allowed for the classification and staging of dogs with dilated cardiomyopathy (DCM) according to established guidelines [22,[38][39][40][41][42][43][44][45]. The dogs exhibited echocardiographic changes indicative of systolic dysfunction, such as increased left ventricular (LV) end-systolic chamber diameter or end-systolic volume, reduced fractional shortening or ejection fraction, and increased E-point to septal separation.…”

“…The dogs exhibited echocardiographic changes indicative of systolic dysfunction, such as increased left ventricular (LV) end-systolic chamber diameter or end-systolic volume, reduced fractional shortening or ejection fraction, and increased E-point to septal separation. Signs of volume overload were also observed, including diastolic LV diameters or volumes exceeding reference ranges [7,14,22,23,37]. Color and spectral Doppler examinations were used to rule out other acquired or congenital cardiac diseases [7].…”

“…Several studies have examined the progression of chronic kidney disease in dogs with myxomatous mitral valve disease, notably those by Martinelli [21] and Yun [22]. The prevalence and impact of CvRD in dogs with DCM have not been extensively studied.…”