多潘立酮联合肾病饮食在减缓利什曼病犬慢性肾病进展中的疗效。

Efficacy of domperidone plus renal diet in slowing the progression of chronic kidney disease in dogs with leishmaniosis.

机构信息

Department of Veterinary Medicine, University of Bari, Valenzano, Italy.

Unit of Research Methodology and Data Sciences for Population Health, "Salus in Apulia Study" National Institute of Gastroenterology "S. de Bellis" Research Hospital, Bari, Italy.

出版信息

Parasit Vectors. 2022 Oct 31;15(1):397. doi: 10.1186/s13071-022-05537-8.

DOI:10.1186/s13071-022-05537-8

PMID:36316751

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9620618/

Abstract

BACKGROUND

Chronic kidney disease (CKD) represents the main cause of mortality in dogs with leishmaniosis. Domperidone has recently been reported to improve kidney function in leishmaniotic dogs affected by CKD. Serum symmetric dimethylarginine (sSDMA) has also been shown to be a useful biomarker for earlier detection of decreased kidney function when compared to serum creatinine (sCr). This study aimed to assess the efficacy of domperidone plus renal diet in slowing the progression of nephropathy in leishmaniotic dogs with CKD, evaluating sSDMA and sCr as markers of kidney function.

METHODS

This study was a therapeutic, prospective, randomized, controlled, 11-month-long field trial. Dogs were recruited if classified as "exposed" to or "infected" with Leishmania infantum and affected by CKD at early stages. After enrolment (T0), dogs were randomized into groups T (treatment) and C (control). All dogs were fed a renal diet and then followed up at 90 (T1), 210 (T2), and 330 (T3) days after inclusion in the study. At T1 and T2, dogs in group T received an oral suspension of domperidone (1 ml/10 kg once a day for up to 28 days).

RESULTS

Twenty-two dogs (i.e., n = 12 in group T and n = 10 in group C) completed the study. At T0, the entire population of enrolled dogs presented a mean sSDMA value of 16.5 ± 3.4 μg/dl. At T1 (i.e., after 3 months of renal diet), sSDMA was significantly decreased in both groups, with an sSDMA of 13.1 ± 4.4 μg/dl for the entire population involved. From T1 to T3, sSDMA gradually increased in group C, while remaining stable in group T, which continued to show a significantly lower value of sSDMA at T3 than at T0. Regarding sCr, at T0 and T1, the mean values of the entire population of dogs were 1.1 ± 0.3 and 1.0 ± 0.4 mg/dl, respectively, with no statistical differences between groups T and C. In group T, sCr decreased significantly from T0 to T1, while returning at T3 to values similar to T0.

CONCLUSIONS

In this study, domperidone plus renal diet reduced the progression of kidney disease in leishmaniotic dogs affected by CKD.

摘要

背景

慢性肾病（CKD）是患利什曼病犬类死亡的主要原因。多潘立酮最近被报道可改善 CKD 患利什曼病犬的肾脏功能。血清对称二甲基精氨酸（sSDMA）也被证明是一种比血清肌酐（sCr）更早检测肾脏功能下降的有用生物标志物。本研究旨在评估多潘立酮加肾脏饮食对减缓 CKD 利什曼病犬肾病进展的疗效，评估 sSDMA 和 sCr 作为肾功能标志物。

方法

这是一项治疗性、前瞻性、随机、对照、为期 11 个月的现场试验。如果犬类被归类为“暴露”或“感染”利什曼原虫，并处于 CKD 早期阶段，则招募这些犬类参与研究。在入组时（T0），将犬类随机分为 T（治疗）组和 C（对照）组。所有犬类均给予肾脏饮食，然后在研究入组后 90（T1）、210（T2）和 330（T3）天进行随访。在 T1 和 T2，T 组的犬类接受多潘立酮口服液（每天 1 次，每次 1 毫升/10 公斤，最多 28 天）。

结果

22 只犬（即 T 组 n=12，C 组 n=10）完成了研究。在 T0，入组犬的整体 sSDMA 值为 16.5±3.4μg/dl。在 T1（即肾脏饮食 3 个月后），两组的 sSDMA 均显著降低，整体 sSDMA 为 13.1±4.4μg/dl。从 T1 到 T3，C 组的 sSDMA 逐渐升高，而 T 组则保持稳定，T3 时的 sSDMA 值仍显著低于 T0。关于 sCr，在 T0 和 T1，犬类整体的平均值分别为 1.1±0.3 和 1.0±0.4mg/dl，T 和 C 两组之间无统计学差异。在 T 组，sCr 从 T0 到 T1 显著下降，而在 T3 时又恢复到与 T0 相似的值。