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猫急性肾实质衰竭:32例(1997 - 2004年)

Acute intrinsic renal failure in cats: 32 cases (1997-2004).

作者信息

Worwag Stefanie, Langston Cathy E

机构信息

Animal Medical Center, 510 E 62nd St, New York, NY 10021, USA.

出版信息

J Am Vet Med Assoc. 2008 Mar 1;232(5):728-32. doi: 10.2460/javma.232.5.728.

Abstract

OBJECTIVE

To determine patient demographics, clinicopathologic findings, and outcome associated with naturally acquired acute intrinsic renal failure (ARF) in cats.

DESIGN

Retrospective case series.

ANIMALS

32 cats with ARF.

PROCEDURES

Cats were considered to have ARF if they had acute onset of clinical signs (< 7 days), serum creatinine concentration > 2.5 mg/dL (reference range, 0.8 to 2.3 mg/dL) and BUN > 35 mg/dL (reference range, 15 to 34 mg/dL) in conjunction with urine specific gravity < 1.025 or with anuria or increasing serum creatinine concentration despite fluid therapy and normal hydration status, and no signs of chronic renal disease. Cases were excluded if cats had renal calculi or renal neoplasia.

RESULTS

Causes of ARF included nephrotoxins (n = 18 cats), ischemia (4), and other causes (10). Eighteen cats were oliguric. For each unit (mEq/L) increase in initial potassium concentration, there was a 57% decrease in chance of survival. Low serum albumin or bicarbonate concentration at initial diagnosis was a negative prognostic indicator for survival. Initial concentrations of BUN, serum creatinine, and other variables were not prognostic. Seventeen (53%) cats survived, of which 8 cats had resolution of azotemia and 9 cats were discharged from the hospital with persistent azotemia.

CONCLUSIONS AND CLINICAL RELEVANCE

Results suggested that survival rates of cats with ARF were similar to survival rates in dogs and that residual renal damage persisted in approximately half of cats surviving the initial hospitalization.

摘要

目的

确定猫自然获得性急性肾实质衰竭(ARF)的患者人口统计学特征、临床病理结果及预后。

设计

回顾性病例系列研究。

动物

32只患有ARF的猫。

方法

若猫出现急性临床症状(<7天)、血清肌酐浓度>2.5mg/dL(参考范围为0.8至2.3mg/dL)且血尿素氮>35mg/dL(参考范围为15至34mg/dL),同时尿比重<1.025或无尿,或尽管进行了液体治疗且水合状态正常但血清肌酐浓度仍升高,且无慢性肾病迹象,则被认为患有ARF。若猫有肾结石或肾肿瘤,则排除该病例。

结果

ARF的病因包括肾毒素(18只猫)、缺血(4只)和其他原因(10只)。18只猫少尿。初始钾浓度每升高1单位(mEq/L),存活几率降低57%。初始诊断时低血清白蛋白或碳酸氢盐浓度是生存的不良预后指标。初始血尿素氮、血清肌酐和其他变量浓度无预后价值。17只(53%)猫存活,其中8只氮质血症消退,9只出院时仍有持续性氮质血症。

结论及临床意义

结果表明,猫ARF的存活率与狗相似,且约一半在初次住院存活的猫存在残余肾损伤。

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