Hyperlipasemia in dogs with acute kidney injury treated with and without hemodialysis

Abstract

Background: Hyperlipasemia has been reported in dogs with acute kidney injury (AKI) but associations with AKI severity, hemodialysis (HD) treatment, and outcome have not been extensively evaluated.Objectives: Investigate the prevalence and clinical relevance of hyperlipasemia in dogs with AKI, treated with and without HD. Animals: Client-owned dogs (n = 125) with AKI. Methods: Retrospective data extraction from medical records, including signalment, cause of AKI, duration of hospitalization, survival, plasma creatinine concentration, and 1,2-o-dilauryl-rac-glycero-3-glutaric acid-(6 0 -methyresorufin) ester (DGGR) lipase activity at admission and throughout hospitalization.Results: A DGGR-lipase activity >3Â the upper reference limit (URL) was found in 28.8% and 55.4% of dogs at admission and during hospitalization, respectively, but only 8.8% and 14.9% of dogs, respectively, were diagnosed with acute pancreatitis. Hyperlipasemia >10 Â URL was observed in 32.7% of dogs during hospitalization.The DGGR-lipase activity was higher in dogs with International Renal Interest Society (IRIS) Grades 4-5 than Grades 1-3, but correlation between DGGR-lipase activity and creatinine concentration was poor (r s = .22; 95% confidence intervals [CI], 0.04-0.38). Treatment with HD was not associated with DGGR-lipase activity independent of IRIS grade. Survival to discharge and 30 days after admission was 65.6% and 59.6%, respectively. High IRIS grades (P = .03) and high DGGR-lipase activity at admission (P = .02) and during hospitalization (P = .003) were associated with nonsurvival.Conclusions and Clinical Importance: Hyperlipasemia is frequent and often marked in dogs with AKI despite only a minority being diagnosed with pancreatitis. Hyperlipasemia is associated with AKI severity but not independently with HD treatment.High IRIS grade and hyperlipasemia were associated with nonsurvival.

Updated ACVIM consensus statement on leptospirosis in dogs

“…These nonspecific changes may reflect pancreatitis, gastroenteritis, or decreased renal elimination. The more specific serum DGGR‐lipase activity (which is increased in 29% of dogs with AKI) seems to be a feature of AKI rather than leptospirosis; it was not different between dogs with and without infectious causes of AKI 84 …”

“…The more specific serum DGGR-lipase activity (which is increased in 29% of dogs with AKI) seems to be a feature of AKI rather than leptospirosis; it was not different between dogs with and without infectious causes of AKI. 84 Urinalysis in dogs with leptospirosis typically shows isosthenuria, but hyposthenuria also has been reported. 66,67,77,79 Renal glucosuria (18%-83%) and cylindruria (8%-67%) are specific indicators of tubular damage.…”