Acute kidney injury in dogs: Etiology, clinical and clinicopathologic findings, prognostic markers, and outcome

Rimer, Dar
Chen, Hilla
Bar-Nathan, Mali
Segev, Gilad

¹Veterinary Teaching Hospital, Koret School of Veterinary Medicine, The Hebrew University of Jerusalem, Rehovot Israel

^*Correspondence Gilad Segev, Koret School of Veterinary Medicine, The Hebrew University of Jerusalem, P.O. Box 12, Rehovot 761001, Israel. Email: [email protected]

revision received January 15, 2022 Received July 08, 2021; Accepted January 20, 2022; previously published online February 01, 2022

This is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made.

Journal of Veterinary Internal Medicine , February 3, 2022. | DOI: 10.1111/jvim.16375

Background

Acute kidney injury (AKI) is a common, potentially fatal condition.

Objectives

To characterize the etiologies, clinical and clinicopathologic findings, hospitalization period, and outcome of dogs with AKI and to identify markers of negative prognosis.

Animals

Two hundred forty-nine client-own dogs diagnosed with AKI and hospitalized at a veterinary teaching hospital.

Methods

Retrospective study. Search of medical records for dogs with AKI.

Results

Common clinical signs included lethargy (225/249, 90%), anorexia (206/249, 83%), and vomiting (168/249, 68%). Etiologies included ischemic/inflammatory (144/249, 58%), infectious (19/249, 8%), nephrotoxicosis (14/249, 6%), or other (13/249, 5%). Hospital-acquired AKI was diagnosed in 9% (23/249) of the dogs. Median presentation and peak serum creatinine (sCr) concentrations were 4 mg/dL (range, 1.1–37.9) and 4.6 mg/dL (range, 1.1–43.1), respectively. Dogs were classified to AKI grades as follows: Grade I, 6 (2%), Grade II, 38 (15%), Grade III, 89 (36%), Grade IV, 77 (31%), and Grade V, 39 (16%). One hundred and sixty-four (66%) dogs survived. There was a positive association between death and AKI grade (P = .009). The case fatality rate was higher among dogs with anuria compared with dogs without anuria (50% vs 28%, respectively; odds ratio [95% confidence interval]: 2.5 [1.39–4.6]; P = .002). Forty-seven (18.8%) dogs underwent hemodialysis, of which 60% survived.

Conclusion and Clinical Importance

Two-thirds of dogs with AKI survived. Hospital-acquired AKI was common. The severity of AKI, as reflected by presence of anuria, AKI grade, and other body organs involvement, was associated with the outcome.