Veterinary Epidemiology, Economics and Public Health, Royal Veterinary College, London, UK.
J Vet Intern Med. 2013 Jul-Aug;27(4):814-21. doi: 10.1111/jvim.12090. Epub 2013 May 6.
The prevalence for chronic kidney disease (CKD) in dogs varies widely (0.05-3.74%). Identified risk factors include advancing age, specific breeds, small body size, and periodontal disease.
HYPOTHESIS/OBJECTIVES: To estimate the prevalence and identify risk factors associated with CKD diagnosis and survival in dogs. Purebred dogs were hypothesized to have higher CKD risk and poorer survival characteristics than crossbred dogs.
A merged clinical database of 107,214 dogs attending 89 UK veterinary practices over a 2-year period (January 2010-December 2011).
A longitudinal study design estimated the apparent prevalence (AP) whereas the true prevalence (TP) was estimated using Bayesian analysis. A nested case-control study design evaluated risk factors. Survival analysis used the Kaplan-Meier survival curve method and multivariable Cox proportional hazards regression modeling.
The CKD AP was 0.21% (95% CI: 0.19-0.24%) and TP was 0.37% (95% posterior credibility interval 0.02-1.44%). Significant risk factors included increasing age, being insured, and certain breeds (Cocker Spaniel, Cavalier King Charles Spaniel). Cardiac disease was a significant comorbid disorder. Significant clinical signs included halitosis, weight loss, polyuria/polydipsia, urinary incontinence, vomiting, decreased appetite, lethargy, and diarrhea. The median survival time from diagnosis was 226 days (95% CI 112-326 days). International Renal Interest Society stage and blood urea nitrogen concentration at diagnosis were significantly associated with hazard of death due to CKD.
Chronic kidney disease compromises dog welfare. Increased awareness of CKD risk factors and association of blood biochemistry results with survival time should facilitate diagnosis and optimize case management to improve animal survival and welfare.
犬慢性肾病（CKD）的患病率差异很大（0.05-3.74%）。已确定的风险因素包括年龄增长、特定品种、体型小和牙周病。
假设/目的：估计 CKD 诊断和犬生存相关的患病率，并确定其风险因素。假设纯种犬比杂种犬患 CKD 的风险更高，生存特征更差。
2 年内（2010 年 1 月至 2011 年 12 月）在 89 家英国兽医诊所就诊的 107214 只犬的合并临床数据库。
采用纵向研究设计估计表观患病率（AP），而使用贝叶斯分析估计真实患病率（TP）。嵌套病例对照研究设计评估风险因素。使用 Kaplan-Meier 生存曲线法和多变量 Cox 比例风险回归模型进行生存分析。
CKD 的 AP 为 0.21%（95%CI：0.19-0.24%），TP 为 0.37%（95%后验可信度区间 0.02-1.44%）。显著的风险因素包括年龄增长、有保险和某些品种（可卡犬、查理王小猎犬）。心脏疾病是一种显著的合并症。显著的临床症状包括口臭、体重减轻、多尿/多饮、尿失禁、呕吐、食欲不振、嗜睡和腹泻。诊断后的中位生存时间为 226 天（95%CI 112-326 天）。国际肾脏学会（IRIS）分期和诊断时的血尿素氮浓度与因 CKD 死亡的危险显著相关。
慢性肾病会损害犬的福利。提高对 CKD 风险因素的认识以及血液生化结果与生存时间的关系，应有助于诊断，并优化病例管理，以提高动物的生存和福利。
