Small Animal Department, Faculty of Veterinary Medicine, Ghent University, Salisburylaan 133, 9820 Merelbeke, Belgium.
Department of Companion Animal Clinical Studies, Faculty of Veterinary Science, University of Pretoria, Pretoria, Onderstepoort 0110, South Africa.
Ticks Tick Borne Dis. 2020 May;11(3):101406. doi: 10.1016/j.ttbdis.2020.101406. Epub 2020 Feb 20.
Dogs with babesiosis can present with multiple complications, including acute kidney injury (AKI). The objective of this study was to characterize AKI in dogs with babesiosis caused by Babesia rossi at presentation and after treatment. Thirty-five client-owned dogs with B. rossi infection and 10 control dogs were included in this prospective observational study. Blood and urine were collected in Babesia-infected dogs at presentation (T, n = 35), after 24 h (T, n = 11), and after 1 month (T, n = 9). The following urinary kidney injury biomarkers were assessed: urinary protein to creatinine ratio (UPC), urinary glomerular injury biomarkers (immunoglobulin G (uIgG) and C-reactive protein (uCRP)), and urinary tubular injury biomarkers (retinol-binding protein (uRBP) and neutrophil gelatinase-associated lipocalin (uNGAL)). Serum functional renal biomarkers were creatinine (sCr) and symmetric dimethylarginine (sSDMA). Post-mortem kidney biopsies were analyzed by light and transmission electron microscopy. At T, all kidney injury biomarkers were significantly higher in Babesia-infected dogs compared to healthy controls (P < 0.001), while functional renal biomarkers were not significantly different (P > 0.05). At T, all urinary tubular injury biomarkers and UPC decreased significantly (P < 0.01), while glomerular injury biomarkers did not (P = 0.084). At T, all urinary kidney injury biomarkers decreased to values not significantly different from healthy controls (P > 0.5). Significant changes in functional renal biomarkers were not seen after treatment (P > 0.05). Dogs with complicated babesiosis had significantly higher glomerular injury biomarkers, UPC, and sSDMA compared to uncomplicated cases (P < 0.05), while all tubular injury biomarkers and sCr were not significantly different (P > 0.1). Dogs with babesiosis caused by B. rossi showed transient kidney injury, which was detected by all kidney injury biomarkers, but remained undetected by functional biomarkers. All infected dogs, irrespective of disease severity, suffered comparable kidney injury based on tubular injury biomarker concentrations, while loss of function was seen more often in dogs with complicated babesiosis based on sSDMA results.
感染巴贝斯虫的犬可能会出现多种并发症，包括急性肾损伤（AKI）。本研究的目的是描述在感染巴贝斯虫时犬的 AKI 特征，并在治疗后进行评估。本前瞻性观察研究纳入了 35 只患有巴贝斯虫感染的犬和 10 只对照犬。在感染巴贝斯虫的犬中，在就诊时（T 期，n=35）、24 小时后（T 期，n=11）和 1 个月后（T 期，n=9）采集血和尿样。评估了以下尿肾损伤生物标志物：尿蛋白/肌酐比值（UPC）、尿肾小球损伤生物标志物（免疫球蛋白 G（uIgG）和 C 反应蛋白（uCRP））和尿小管损伤生物标志物（视黄醇结合蛋白（uRBP）和中性粒细胞明胶酶相关脂质运载蛋白（uNGAL））。血清功能肾生物标志物为肌酐（sCr）和对称二甲基精氨酸（sSDMA）。通过光镜和透射电镜分析死后肾活检。在 T 期，所有肾损伤生物标志物在感染巴贝斯虫的犬中均明显高于健康对照组（P<0.001），而功能肾生物标志物无显著差异（P>0.05）。在 T 期，所有尿小管损伤生物标志物和 UPC 均显著降低（P<0.01），而肾小球损伤生物标志物无显著变化（P=0.084）。在 T 期，所有尿肾损伤生物标志物均降低至与健康对照组无显著差异的水平（P>0.5）。治疗后未见功能肾生物标志物显著变化（P>0.05）。患有复杂巴贝斯虫感染的犬的肾小球损伤生物标志物、UPC 和 sSDMA 明显高于无并发症的病例（P<0.05），而所有小管损伤生物标志物和 sCr 无显著差异（P>0.1）。感染巴贝斯虫的犬存在短暂的肾损伤，所有肾损伤生物标志物均可检测到，但功能生物标志物无法检测到。所有感染犬，无论疾病严重程度如何，根据小管损伤生物标志物浓度，均有相似的肾损伤，而根据 sSDMA 结果，患有复杂巴贝斯虫感染的犬更容易出现功能丧失。
