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先天性门体循环血管异常犬手术结扎前后的肾小球滤过率和肾体积

Glomerular filtration rate and renal volume in dogs with congenital portosystemic vascular anomalies before and after surgical ligation.

作者信息

Deppe T A, Center S A, Simpson K W, Erb H N, Randolph J F, Dykes N L, Yeager A E, Reynolds A J

机构信息

Department of Clinical Sciences, College of Veterinary Medicine, Cornell University, Ithaca, NY 14853-6401, USA.

出版信息

J Vet Intern Med. 1999 Sep-Oct;13(5):465-71. doi: 10.1892/0891-6640(1999)013<0465:gfrarv>2.3.co;2.

Abstract

Glomerular filtration rate (GFR) and renal volume were evaluated in dogs with confirmed portosystemic vascular anomalies (PSVA) before and after surgical ligation of their PSVA. Pre- and postligation CBC, serum biochemistry, urinalysis, abdominal ultrasonography with measurement of renal volume, and per rectal scintigraphy were performed to document resolution of abnormalities consistent with portosystemic shunting. GFR was estimated by plasma 99mTc-diethylenetriaminepentaacetic acid (99mTc-DTPA) clearance before (n = 21) and after (n = 12) surgical correction of PSVA. Preligation 99mTc-DTPA GFR was increased (median, 5.64 mL/minute/kg; range, 3.53-8.49 mL/minute/kg; reference range, 2.83-4.47 mL/minute/kg) in 81% (17/21) of dogs. Postligation 99mTc-DTPA GFR decreased in all 12 evaluated dogs (median change = -42%; P < .001). Preligation renal volume was above the reference range for the left and right kidneys in 71% (10/14) and 69% (11/16) of dogs evaluated, respectively. Right renal volume decreased significantly (n = 5; median change, -45%; P = .03) after surgical ligation of PSVA. These findings document increased GFR and renal volume in dogs with PSVA, which may explain in part the low blood urea nitrogen and serum creatinine concentrations encountered in these dogs. Knowledge of changes in GFR associated with PSVA ligation may prove helpful in the anesthetic, drug, and dietary management of affected dogs.

摘要

在患有确诊的门体循环血管异常(PSVA)的犬类中,在手术结扎其PSVA之前和之后评估了肾小球滤过率(GFR)和肾脏体积。在结扎前后进行全血细胞计数(CBC)、血清生化检查、尿液分析、测量肾脏体积的腹部超声检查以及经直肠闪烁扫描,以记录与门体分流一致的异常情况的缓解。通过血浆99m锝-二乙三胺五乙酸(99mTc-DTPA)清除率在PSVA手术矫正前(n = 21)和后(n = 12)估计GFR。结扎前,81%(17/21)的犬类99mTc-DTPA GFR升高(中位数,5.64 mL/分钟/千克;范围,3.53 - 8.49 mL/分钟/千克;参考范围,2.83 - 4.47 mL/分钟/千克)。在所有12只接受评估的犬类中,结扎后99mTc-DTPA GFR均下降(中位数变化 = -42%;P <.001)。在分别评估的犬类中,71%(10/14)和69%(11/16)的犬类结扎前门体循环血管异常(PSVA)的左肾和右肾体积高于参考范围。PSVA手术结扎后,右肾体积显著下降(n = 5;中位数变化,-45%;P =.03)。这些发现证明患有PSVA的犬类GFR和肾脏体积增加,这可能部分解释了这些犬类中遇到的低血尿素氮和血清肌酐浓度。了解与PSVA结扎相关的GFR变化可能有助于对受影响犬类的麻醉、药物和饮食管理。

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