Prevalence of acute kidney injury in a population of hospitalized horses

Abstract

Background Hospital‐acquired acute kidney injury (AKI) in humans and dogs increases morbidity and nonsurvival. Azotemia at presentation has been associated with a poor outcome in horses; however, prevalence and consequences of hospital‐acquired AKI are unreported. Hypothesis/Objectives To evaluate the prevalence of AKI in hospitalized horses, risk factors associated with AKI, and the effect of AKI on short‐term survival. We hypothesized that the prevalence of AKI in horses is similar to that reported in other domestic mammalian species and would be associated with nonsurvival. Animals Adult horses hospitalized for >2 days from which a minimum of 2 measurements of serum creatinine concentration were available. Methods Retrospective cohort study. Clinical records were reviewed and horses grouped according to their baseline serum creatinine concentration and change in serum creatinine concentration from baseline. The associations between signalment, diagnosis, and treatment variables, and the presence of azotemia or AKI were assessed using multinomial logistic regression. The relationship between these conditions and survival to discharge was evaluated. Results Three hundred twenty‐five horses were included; 4.3% (14/325) had azotemia at baseline and 14.8% (48/325) developed AKI. There were no significant associations between investigated risk factors and development of AKI. The presence of azotemia and AKI did not significantly affect survival to discharge (P = .08 and .81, respectively). Conclusions and Clinical Importance The prevalence of AKI in this population of hospitalized horses is similar to that reported in dogs and humans; however, in this study population, there was less impact on morbidity and short‐term survival.

Serum symmetric dimethylarginine concentration in healthy horses and horses with acute kidney injury

“…In contrast to studies on dogs and cats, there is scarce literature on the prevalence of kidney diseases, including acute kidney injury (AKI) in the general equine population. However, there are several reports of AKI in horses, with increasing prevalence in intensive care units [1][2][3].…”

“…In contrast to studies on dogs and cats, there is scarce literature on the prevalence of kidney diseases, including acute kidney injury (AKI) in the general equine population. However, there are several reports of AKI in horses, with increasing prevalence in intensive care units [ 1 – 3 ]. Currently, kidney disease in horses is diagnosed based on increased serum creatinine and urea levels, abnormal urinalysis and ultrasonographic lesions detected in kidneys.…”

Efeitos adversos do uso prolongado de anti-inflamatórios não esteroidais inibidores da COX-2 em equinos: revisão

“…A sCR é um indicador comumente usado para avaliação da Taxa de Filtração Glomerular (TFG), porém é um marcador de baixa sensibilidade da função renal, pois só aumenta após uma perda de aproximadamente 75% da TFG, o que demonstra a severidade dos danos nos nefros. Além disso a sCR pode sofrer variações com a idade, raça, sexo e massa muscular (Savage et al, 2019;Schott II & Esser, 2019).…”

“…Historicamente, variações na definição de LRA tem dificultado a identificação e classificação dos pacientes, e azotemia grave (> 10mg/dL sCR) ou persistente (duração acima Research, Society and Development, v. 9, n. 9, e609997747, 2020 (CC BY 4.0) | ISSN 2525-3409 | DOI: http://dx.doi.org/10.33448/rsd-v9i9.7747 de 72 horas) está associada a prognóstico ruim para a vida. Diante disso, Savage et al, (2019), baseados em estudos em humanos, propuseram um sistema veterinário de estágios para LRA em cavalos usando os valores de sCR do paciente no momento da admissão no internamento clínico (ou valor basal, se disponível) durante os sete dias iniciais do processo, com pelo menos duas medições, o sistema VAKI, (Veterinary Acute Kidney Injury), onde: Estágio (Es) 0 = aumento na sCR > 150% do valor de base;…”

“…Sua concentração sérica pode aumentar com a perda de apenas 40% da massa renal funcional e sua mensuração aumentou em média 10 e 17 meses mais cedo do que a sCR em cães e gatos, respectivamente, com DRC. Os estudos com a SDMA em cavalos com LRA e DRC mostram-se promissores (Savage et al, 2019;Schott II & Esser, 2019). Development, v. 9, n. 9, e609997747, 2020 (CC BY 4.0) | ISSN 2525-3409 | DOI: http://dx.doi.org/10.33448/rsd-v9i9.7747 13 Em cavalos com cólica foi identificado o aumento da metaloproteinase-9 da matriz urinária, o que pode estar relacionado a dano tubular renal precoce.…”