School of Biodiversity, One Health and Veterinary Medicine, The University of Glasgow Small Animal Hospital, 464 Bearsden Road, Glasgow, G61 1QH, Scotland.
Division of Veterinary Epidemiology and Economics, Institute of Veterinary Medicine, Warsaw University of Life Sciences-SGGW, Nowoursynowska 159c, 02-776, Warsaw, Poland.
J Small Anim Pract. 2023 Dec;64(12):749-758. doi: 10.1111/jsap.13669. Epub 2023 Aug 26.
To assess relationships between urine sediment and microbial culture findings and the presence of proteinuria in canine urine samples, and to assess the change in the percentage of proteinuric samples and urine protein-to-creatinine ratio when urine abnormalities resolve.
Canine urine samples collected via cystocentesis and submitted for culture and contemporaneous urinalysis (including urine protein-to-creatinine ratio) were retrospectively identified. Dogs receiving corticosteroids were excluded. Associations between haematuria (red blood cells>5/high-power field), pyuria (white blood cells>5/high-power field), presence of microorganisms on microscopy, active sediment, and positive culture and proteinuria (urine protein-to-creatinine ratio>0.5) were investigated. Patient characteristics were considered possible confounders. In dogs with repeat urinalysis, the associations between active sediment and positive culture resolution on proteinuria and urine protein-to-creatinine ratio were assessed.
One hundred and ninety-two of 491 samples were proteinuric (39.1%). Age was positively associated with proteinuria. In the multivariable analysis corrected for age, active sediment was the only variable significantly associated with proteinuria (adjusted odds ratio: 2.12; 95% confidence interval: 1.44 to 3.11); however, only 49.8% of samples with active sediment were proteinuric. Neither resolution of active sediment nor positive culture were associated with reduced proportions of proteinuric samples (from 57.9% to 42.1% and from 40.0% to 25.0%, respectively) or significant reductions in urine protein-to-creatinine ratio (median change: -0.16 and -0.14, respectively).
Attributing proteinuria to urinalysis abnormalities or a positive urine culture in canine cystocentesis samples is not supported by our findings, and could result in alternative causes of proteinuria (e.g. renal proteinuria) being overlooked.
评估犬尿液沉淀物和微生物培养结果与蛋白尿之间的关系，并评估尿液异常缓解时蛋白尿样本和尿蛋白/肌酐比值的百分比变化。
通过膀胱穿刺术收集的犬尿液样本，并进行培养和同时进行尿液分析（包括尿蛋白/肌酐比值），回顾性识别。排除接受皮质类固醇治疗的犬。研究血尿（红细胞>5/高倍视野）、脓尿（白细胞>5/高倍视野）、显微镜下存在微生物、活跃沉淀物和阳性培养与蛋白尿（尿蛋白/肌酐比值>0.5）之间的关系。患者特征被认为是可能的混杂因素。在有重复尿液分析的犬中，评估活跃沉淀物与阳性培养对蛋白尿和尿蛋白/肌酐比值的关系。
491 个样本中有 192 个（39.1%）蛋白尿。年龄与蛋白尿呈正相关。在多变量分析中，校正年龄后，活跃沉淀物是唯一与蛋白尿显著相关的变量（调整优势比：2.12；95%置信区间：1.44 至 3.11）；然而，只有 49.8%有活跃沉淀物的样本蛋白尿。活跃沉淀物的解决或阳性培养均与蛋白尿样本的比例降低无关（分别从 57.9%降至 42.1%和从 40.0%降至 25.0%），或尿蛋白/肌酐比值无显著降低（中位数变化：-0.16 和-0.14）。
我们的研究结果不支持将犬膀胱穿刺术样本中的蛋白尿归因于尿液分析异常或阳性尿液培养，这可能导致忽略其他蛋白尿的原因（例如，肾性蛋白尿）。
