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对有风险因素治疗性管理的犬慢性肾病进展的评估

Evaluation of Chronic Kidney Disease Progression in Dogs With Therapeutic Management of Risk Factors.

作者信息

Perini-Perera Sofía, Del-Ángel-Caraza Javier, Pérez-Sánchez Alicia Pamela, Quijano-Hernández Israel Alejandro, Recillas-Morales Sergio

机构信息

Facultad de Medicina Veterinaria y Zootecnia, Hospital Veterinario para Pequeñas Especies, Universidad Autónoma del Estado de Mexico, Toluca, Mexico.

Facultad de Medicina Veterinaria y Zootecnia, Universidad Autónoma del Estado de Mexico, Toluca, Mexico.

出版信息

Front Vet Sci. 2021 May 5;8:621084. doi: 10.3389/fvets.2021.621084. eCollection 2021.

Abstract

This research was performed to describe the characteristics of the progression of naturally occurring chronic kidney disease (CKD) in dogs, together with the management of identified risk factors, following the International Renal Interest Society recommendations. Dogs diagnosed and staged with CKD, and with a longitudinal follow-up from the moment of diagnosis of up to a maximum of 730 days, were included. A total of 545 dogs that presented risk factors for the development of CKD were analyzed, out of which 36 met the inclusion criteria. Advanced age was identified in 80.6% of cases. Initiation risk factors were represented by inflammatory/infectious diseases, history of anesthetic-surgical procedures, heart disease, neoplasms, endocrinopathies, and exposure to nephrotoxic drugs. During the follow-up period, progression of CKD was identified in 47.2% of the cases, being more salient in advanced stages. Serum symmetric dimethyl arginine (SDMA) was the only glomerular filtration rate (GFR) marker which displayed differences among studied times during early stages of CKD, associated with the disease progression and decline of renal function. A significant difference between the survival curves in early and advanced CKD stages was observed. The factors related to decreased survival were hyperphosphatemia, anemia, and low body condition score (BCS). No differences were found between the presence of arterial hypertension and renal proteinuria and decreased survival. Furthermore, CKD diagnosis based on the persistent finding of abnormalities in early disease markers, such as serum symmetric dimethyl arginine increase and/or renal proteinuria, and timely therapeutic management of risk factors, allowed for CKD stabilization, reducing progression to advanced stages, and favoring higher survival rates.

摘要

本研究旨在描述犬自然发生的慢性肾脏病(CKD)的进展特征,以及按照国际肾脏利益协会的建议对已识别的风险因素进行管理。纳入了被诊断为CKD并进行分期,且从诊断时刻起进行最长730天纵向随访的犬。总共分析了545只存在CKD发生风险因素的犬,其中36只符合纳入标准。80.6%的病例为老龄犬。起始风险因素包括炎症/感染性疾病、麻醉手术史、心脏病、肿瘤、内分泌疾病以及接触肾毒性药物。在随访期间,47.2%的病例出现了CKD进展,在晚期更为显著。血清对称二甲基精氨酸(SDMA)是唯一在CKD早期各研究时间点显示出差异的肾小球滤过率(GFR)标志物,与疾病进展和肾功能下降相关。观察到CKD早期和晚期生存曲线之间存在显著差异。与生存率降低相关的因素为高磷血症、贫血和低体况评分(BCS)。动脉高血压和肾蛋白尿的存在与生存率降低之间未发现差异。此外,基于早期疾病标志物(如血清对称二甲基精氨酸升高和/或肾蛋白尿)持续异常的发现进行CKD诊断,并及时对风险因素进行治疗管理,可使CKD病情稳定,减少进展至晚期,并提高生存率。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c5c3/8131674/a48752639d1c/fvets-08-621084-g0001.jpg

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