Fischer Hendryk, Geisen Vera, Dorsch Roswitha, Hartmann Katrin, Dörfelt René
LMU Small Animal Clinic, LMU Munich, Veterinaerstrasse 13, 80539 Munich, Germany.
Vet World. 2023 Jun;16(6):1214-1221. doi: 10.14202/vetworld.2023.1214-1221. Epub 2023 Jun 5.
Humans and dogs with azotemia can develop coagulation disorders. Therefore, this study aimed to evaluate the coagulation profiles and thromboelastographic parameters in dogs with acute kidney injury (AKI) and chronic kidney disease (CKD).
In this prospective study, 31 client-owned dogs with renal azotemia (creatinine >220 μmol/L) were enrolled. Clinical signs of hemostatic disorders, complete blood count, coagulation profile, D-dimers, thromboelastography, and 28-day survival data were obtained and analyzed using the t-test, Mann-Whitney U test, and Chi-square test. Statistical significance was set at p < 0.05.
Seventeen dogs with AKI, 10 with CKD, and four with acute-on-chronic kidney injury (AoC) were enrolled. Ten dogs (AKI, 8/17; CKD, 2/10) had thrombocytopenia. Prothrombin time was prolonged in four dogs with AKI and longer in dogs with AKI than in dogs with CKD (p = 0.004). The activated partial thromboplastin time was prolonged in 23 dogs (AKI, 14/17; CKD, 7/10; AoC, 3/4) and was longer in azotemic dogs than in healthy control dogs (p = 0.003). Thromboelastographic tracings were hypocoagulable in three dogs with AKI and hypercoagulable in 16 dogs (AKI 4/17, CKD 9/10, AoC 3/4). The thromboelastographic values for maximum amplitude (p < 0.001) and global clot strength (p < 0.001) were lower in dogs with AKI than in those with CKD.
Hypercoagulable thromboelastographic tracings were observed in dogs with CKD, whereas coagulation times were prolonged in dogs with AKI. However these findings should be validated by further studies.
患有氮质血症的人类和犬类会出现凝血功能障碍。因此，本研究旨在评估急性肾损伤（AKI）和慢性肾病（CKD）犬的凝血谱和血栓弹力图参数。
在这项前瞻性研究中，纳入了31只客户拥有的患有肾性氮质血症（肌酐>220μmol/L）的犬。获取止血障碍的临床体征、全血细胞计数、凝血谱、D - 二聚体、血栓弹力图以及28天生存数据，并使用t检验、曼 - 惠特尼U检验和卡方检验进行分析。统计学显著性设定为p < 0.05。
纳入了17只患有AKI的犬、10只患有CKD的犬和4只患有急性慢性肾损伤（AoC）的犬。10只犬（AKI，8/17；CKD，2/10）有血小板减少症。4只患有AKI的犬凝血酶原时间延长，且患有AKI的犬比患有CKD的犬凝血酶原时间更长（p = 0.004）。23只犬（AKI，14/17；CKD，7/10；AoC，3/4）活化部分凝血活酶时间延长，且氮质血症犬比健康对照犬更长（p = 0.003）。3只患有AKI的犬血栓弹力图描记呈低凝状态，16只犬（AKI 4/17，CKD 9/10，AoC 3/4）呈高凝状态。患有AKI的犬血栓弹力图的最大振幅（p < 0.001）和整体凝血强度（p < 0.001）值低于患有CKD的犬。
在患有CKD的犬中观察到血栓弹力图描记呈高凝状态，而患有AKI的犬凝血时间延长。然而，这些发现需要进一步研究来验证。
