Segev Gilad, Bruchim Yaron, Berl Noga, Cohen Adar, Aroch Itamar
Department of Small Animals Medicine, Koret School of Veterinary Medicine, Hebrew University, Jerusalem, Israel.
J Vet Intern Med. 2018 May;32(3):1109-1115. doi: 10.1111/jvim.15081. Epub 2018 Mar 25.
Acute kidney injury (AKI) is common in dogs, but evidence of efficacy of its treatment is lacking.
To evaluate the efficacy of fenoldopam in the management of AKI.
Forty dogs with naturally occurring heatstroke.
Dogs were prospectively enrolled and divided into treatment and the placebo groups (fenoldopam, constant rate infusion [CRI] of 0.1 µg/kg/min or saline, respectively). Urine production (UP) was measured using a closed system. Urinary clearances were performed at 4, 12, and 24 hours after presentation to estimate the effect of fenoldopam on UP, glomerular filtration rate (GFR) and sodium fractional excretion (NaFE).
At presentation, severity of heatstroke, based on a previously developed scoring system, was similar between the study groups, but was significantly worse in nonsurvivors compared with survivors. Fenoldopam administration was not associated with hypotension. Overt AKI was diagnosed, based on the International Renal Interest Society guidelines in 22/40 (55%) of the dogs. Overall, 14/40 dogs (35%) died, with no significant (P = .507) mortality rate difference between the fenoldopam (6/20 dogs; 30%) and placebo (8/20; 40%) groups. The proportion of dogs with AKI did not differ between the fenoldopam and the placebo groups (9/20; 45% versus 13/20; 65%, respectively; P = .204). There were no differences in UP, GFR, and NaFE between the fenoldopam and the placebo groups.
Fenoldopam CRI at 0.1 µg/kg/min did not have a clinically relevant effect on kidney function parameters in dogs with severe heatstroke-associated AKI.
急性肾损伤(AKI)在犬类中很常见,但缺乏其治疗效果的证据。
评估非诺多泮治疗AKI的疗效。
40只自然发生中暑的犬。
前瞻性纳入犬只并分为治疗组和安慰剂组(分别为非诺多泮,以0.1μg/kg/min的速率持续静脉输注[CRI]或生理盐水)。使用封闭系统测量尿量(UP)。在就诊后4、12和24小时进行尿清除率测定,以评估非诺多泮对UP、肾小球滤过率(GFR)和钠分数排泄(NaFE)的影响。
就诊时,根据先前制定的评分系统,研究组之间中暑严重程度相似,但与存活犬相比,非存活犬的情况明显更糟。给予非诺多泮与低血压无关。根据国际肾脏病学会指南,40只犬中有22只(55%)被诊断为明显的AKI。总体而言,40只犬中有14只(35%)死亡,非诺多泮组(20只犬中有6只;30%)和安慰剂组(20只中有8只;40%)之间的死亡率无显著差异(P = 0.507)。非诺多泮组和安慰剂组中患有AKI的犬的比例没有差异(分别为9/20;45%对13/20;65%;P = 0.204)。非诺多泮组和安慰剂组之间的UP、GFR和NaFE没有差异。
以0.1μg/kg/min的速率持续静脉输注非诺多泮对患有严重中暑相关AKI的犬的肾功能参数没有临床相关影响。