IDEXX Laboratories, Inc., Westbrook, ME 04092, USA.
IDEXX Laboratories, Inc., Westbrook, ME 04092, USA.
Top Companion Anim Med. 2021 Mar;42:100491. doi: 10.1016/j.tcam.2020.100491. Epub 2020 Nov 2.
Lyme disease is a multi-faceted illness caused by infection due to Borrelia burgdorferi. Acute kidney damage secondary to Lyme disease is well described but less so as a chronic event. The role of Anaplasma spp. and secondary kidney dysfunction is not known. A retrospective cohort study was performed to determine if dogs within a defined Lyme disease and anaplasmosis region with B. burgdorferi or Anaplasma spp. antibodies had an increased risk of chronic kidney disease (CKD). Patient exposure was defined as having a B. burgdorferi or Anaplasma spp. antibody positive result recorded at any point in the available patient history. CKD was defined as concurrent increased symmetric dimethylarginine and creatinine (Cr) for a minimum of 25 days with inappropriate urine specific gravity (USG). Patients were matched using propensity scoring to control for age, region, and breed. Contingency tables were used to compare dogs seropositive and not seropositive to B. burgdorferi and Anaplasma spp. and CKD outcome. For each comparison that was performed, statistical significance was defined by a P-value of <.025. The risk ratio of CKD for patients exposed to B. burgdorferi and Anaplasma spp. were found to be 1.43 (95% confidence interval [CI, 1.27, 1.61], P < .0001) and 1.04, (95% CI [0.87, 1.24], P = .6485), respectively. Results suggest in this cohort no increased risk for developing CKD when exposed to Anaplasma spp. but a significant increase in risk for developing CKD with exposure to B. burgdorferi.
莱姆病是一种由伯氏疏螺旋体引起的多方面感染性疾病。莱姆病引起的急性肾损伤已有详细描述，但作为慢性事件则较少见。关于安氏巴尔通体和继发性肾功能障碍的作用尚不清楚。本研究进行了一项回顾性队列研究，以确定在一个明确的莱姆病和无形体病区域内，具有伯氏疏螺旋体或安氏巴尔通体抗体的狗是否有发生慢性肾病（CKD）的风险增加。患者暴露定义为在可用的患者病史记录中任何时间点具有伯氏疏螺旋体或安氏巴尔通体抗体阳性结果。CKD 的定义为同时出现对称性二甲基精氨酸和肌酐（Cr）增加至少 25 天，且尿液比重（USG）不适当。使用倾向评分对患者进行匹配，以控制年龄、地区和品种。使用列联表比较了对伯氏疏螺旋体和安氏巴尔通体抗体呈阳性和阴性的狗与 CKD 结果。对于执行的每一次比较，均通过 P 值 <.025 来定义统计学意义。发现暴露于伯氏疏螺旋体和安氏巴尔通体的患者发生 CKD 的风险比分别为 1.43（95%置信区间[CI]，1.27，1.61]，P <.0001）和 1.04（95%CI [0.87，1.24]，P =.6485）。结果表明，在本队列中，暴露于安氏巴尔通体时，发生 CKD 的风险没有增加，但暴露于伯氏疏螺旋体时，发生 CKD 的风险显著增加。
