J Am Vet Med Assoc. 2023 Aug 15;261(11):1-10. doi: 10.2460/javma.23.04.0184. Print 2023 Nov 1.
To identify the frequency of and risk factors for acute kidney injury (AKI) in dogs undergoing abdominal surgery for septic peritonitis, and to evaluate outcome and kidney-related risk factors for survival to discharge in those dogs.
77 dogs that underwent abdominal surgery for septic peritonitis.
Medical records of dogs that underwent surgery for septic peritonitis from 2012 through 2022 were reviewed. Data regarding signalment, clinical and biochemical findings at presentation, blood creatinine concentration throughout hospitalization, surgery characteristics, postoperative monitoring, and outcome were collected. Dogs were classified based on occurrence of AKI and whether they presented with or developed AKI in-hospital. Perioperative risk factors were evaluated, and outcomes were compared with univariable logistic regression.
31 dogs (40.3%) had AKI diagnosed; 18/77 (23.4%) dogs presented with AKI, 11 (61.1%) of which had it postoperatively, and 13/77 (16.9%) dogs developed AKI postoperatively. Significant factors for presenting with AKI included increasing baseline respiratory rate (OR 2.5 for every 10 beats per minute higher), decreasing systolic blood pressure (OR 0.8 for every 10 mm Hg higher), and increasing body condition score (OR 2.2 for every score greater). No significant factors for developing AKI postoperatively were identified after multiple comparisons adjustment. Sixteen dogs (20.8%) did not survive to discharge; 12 (75.0%) had AKI and 4 (25.0%) did not. Dogs with AKI had decreased odds of survival to discharge (OR 0.2).
AKI was common in dogs with septic peritonitis and was a significant risk factor for survival to discharge. Clinical surveillance of AKI is critical in this population.
确定因败血性腹膜炎行腹部手术的犬发生急性肾损伤（AKI）的频率和风险因素，并评估这些犬出院时的结局和与肾脏相关的生存风险因素。
77 只因败血性腹膜炎而行腹部手术的犬。
回顾了 2012 年至 2022 年间因败血性腹膜炎而行手术的犬的病历。收集了有关品种、就诊时的临床和生化检查结果、住院期间的血肌酐浓度、手术特征、术后监测和结局的数据。根据 AKI 的发生情况以及犬是否在院内出现或发展为 AKI 对犬进行分类。评估了围手术期的风险因素，并通过单变量逻辑回归比较了结局。
31 只犬（40.3%）诊断为 AKI；77 只犬中有 18 只（23.4%）出现 AKI，其中 11 只（61.1%）为术后出现，13 只（16.9%）为术后发生 AKI。出现 AKI 的显著因素包括：基础呼吸频率增加（每增加 10 次/分钟，风险增加 2.5）、收缩压降低（每增加 10mmHg，风险降低 0.8）和体况评分增加（每增加 1 分，风险增加 2.2）。在多次比较调整后，未发现术后发生 AKI的显著因素。16 只犬（20.8%）未存活至出院；其中 12 只（75.0%）发生 AKI，4 只（25.0%）未发生 AKI。发生 AKI 的犬存活至出院的可能性降低（OR 0.2）。
AKI 在患有败血性腹膜炎的犬中很常见，是存活至出院的重要风险因素。在该人群中，对 AKI 的临床监测至关重要。
