Bacic Angela, Kogika Márcia M, Barbaro Kátia C, Iuamoto Cristina S, Simões Denise M N, Santoro Marcelo L
School of Veterinary Medicine, University of São Paulo, São Paulo, SP CEP 05508-270, Brazil.
Vet Clin Pathol. 2010 Jun;39(2):203-9. doi: 10.1111/j.1939-165X.2009.00207.x. Epub 2010 Jan 4.
Microalbuminuria and hypertension have long been associated with a guarded prognosis in human patients with a variety of diseases. In veterinary medicine, tests for microalbuminuria have been used for detecting early kidney damage, but there is little information regarding its association with high blood pressure in dogs with chronic kidney disease (CKD).
The objective of this study was to evaluate albuminuria and its association with arterial hypertension in dogs with CKD.
Urinary albumin:creatinine (UAC) ratio, urinary protein:creatinine (UPC) ratio, and systolic blood pressure were determined in 39 clinically healthy dogs and 40 dogs with CKD.
UAC in dogs with CKD (range, 0.002-7.99; median, 0.38) was statistically different from that of control dogs (range, 0.0005-0.01; median, 0.002). Microalbuminuria (UAC 0.03-0.3) and macroalbuminuria (UAC>0.3) were detected in 32.5% and 50% of dogs with CKD, respectively. Sixty percent (24/40) of dogs with CKD had systolic pressure > or =180 mmHg; in these dogs, UAC ratio (range, 0.006-7.99; median, 1.72) was significantly higher than in dogs with CKD and systolic pressure<180 mmHg (range, 0.002-4.83; median, 0.10). Of hypertensive dogs with CKD, those with UPC>1.0 usually had macroalbuminuria, those with UPC 0.5-1.0 usually had microalbuminuria, and those with UPC<0.5 usually lacked albuminuria.
UAC ratio was higher in hypertensive than in normotensive dogs with CKD. Tests designed to detect microalbuminuria may be useful for hypertensive dogs with CKD and a UPC < or = 1.0 to detect the onset and magnitude of albuminuria. Once macroalbuminuria is overt, the UPC ratio itself can be used for the same purpose.
长期以来，微量白蛋白尿和高血压与患有各种疾病的人类患者的预后不良相关。在兽医学中，微量白蛋白尿检测已用于检测早期肾脏损伤，但关于其与慢性肾脏病（CKD）犬高血压之间的关联信息较少。
本研究的目的是评估CKD犬的蛋白尿及其与动脉高血压的关联。
测定了39只临床健康犬和40只CKD犬的尿白蛋白：肌酐（UAC）比值、尿蛋白：肌酐（UPC）比值和收缩压。
CKD犬的UAC（范围为0.002 - 7.99；中位数为0.38）与对照犬（范围为0.0005 - 0.01；中位数为0.002）在统计学上有差异。分别在32.5%和50%的CKD犬中检测到微量白蛋白尿（UAC 0.03 - 0.3）和大量白蛋白尿（UAC>0.3）。60%（24/40）的CKD犬收缩压≥180 mmHg；在这些犬中，UAC比值（范围为0.006 - 7.99；中位数为1.72）显著高于收缩压<180 mmHg的CKD犬（范围为0.002 - 4.83；中位数为0.10）。在患有CKD的高血压犬中，UPC>1.0的犬通常有大量白蛋白尿，UPC 0.5 - 1.0的犬通常有微量白蛋白尿，UPC<0.5的犬通常无白蛋白尿。
高血压CKD犬的UAC比值高于血压正常的CKD犬。旨在检测微量白蛋白尿的检测方法可能有助于UPC≤1.0的高血压CKD犬检测白蛋白尿的发生和程度。一旦出现大量白蛋白尿，UPC比值本身可用于相同目的。
