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健康犬和慢性肾病犬尿液白蛋白与肌酐比值用于早期肾病诊断的验证。

Diagnostic validation of the urine albumin-to-creatinine ratio for early renal disease in healthy dogs and dogs with chronic kidney disease.

机构信息

Department of Veterinary Internal Medicine, College of Veterinary Medicine, Konkuk University, Seoul 05029, Korea.

Department of Bio-Animal Health, Jangan University, Hwaseong 18331, Korea.

出版信息

J Vet Sci. 2024 Nov;25(6):e77. doi: 10.4142/jvs.24183.

DOI:10.4142/jvs.24183
PMID:39608771
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11611491/
Abstract

IMPORTANCE

This paper highlights the urine albumin-to-creatinine ratio (UAC) as a valuable biomarker for the early detection of chronic kidney disease (CKD) in dogs. The UAC effectively distinguishes between healthy dogs and those with CKD, particularly in the early stages, and enhances diagnostic accuracy when used alongside other renal biomarkers.

OBJECTIVE

To evaluate the utility of the UAC as a biomarker for early CKD diagnosis in dogs and examine its correlation with other renal biomarkers in a large-scale clinical study.

METHODS

This study included 99 healthy dogs and 122 dogs with CKD. The UAC and other renal biomarkers were measured and evaluated in healthy dogs and those with CKD and categorized according to the staging criteria of the International Renal Interest Society (IRIS).

RESULTS

Dogs with CKD had significantly higher UACs than healthy dogs ( < 0.05). The UAC correlated with the IRIS stages and other renal biomarkers ( < 0.05). Receiver operating characteristic curve analysis yielded an area under the curve of 0.817 ( < 0.05) for the UAC, with a cut-off value of 19.20 mg/g, showing 72% sensitivity and 71% specificity. A "grey zone" diagnostic window for early-stage CKD was introduced.

CONCLUSIONS AND RELEVANCE

The UAC is effective for the early diagnosis of renal disease in dogs. The UAC can differentiate between healthy dogs and those with CKD at IRIS stage 1. The diagnostic value is enhanced when used alongside other renal biomarkers, allowing for more specific guidelines for pet owners and veterinarians. This large-scale study addresses the limitations of previous research conducted on small clinical samples.

摘要

重要性

本文强调了尿白蛋白与肌酐比值(UAC)作为一种有价值的生物标志物,可用于早期检测犬慢性肾脏病(CKD)。UAC 可有效区分健康犬和 CKD 犬,尤其是在早期阶段,并且当与其他肾脏生物标志物一起使用时,可提高诊断准确性。

目的

评估 UAC 作为犬早期 CKD 诊断生物标志物的效用,并在一项大规模临床研究中检查其与其他肾脏生物标志物的相关性。

方法

本研究纳入了 99 只健康犬和 122 只 CKD 犬。在健康犬和 CKD 犬中测量和评估了 UAC 和其他肾脏生物标志物,并根据国际肾脏学会(IRIS)的分期标准进行分类。

结果

CKD 犬的 UAC 明显高于健康犬(<0.05)。UAC 与 IRIS 分期和其他肾脏生物标志物相关(<0.05)。受试者工作特征曲线分析得出 UAC 的曲线下面积为 0.817(<0.05),截断值为 19.20mg/g,显示 72%的敏感性和 71%的特异性。引入了一个早期 CKD 的“灰色区域”诊断窗口。

结论和相关性

UAC 可有效用于犬肾脏疾病的早期诊断。UAC 可在 IRIS 1 期区分健康犬和 CKD 犬。当与其他肾脏生物标志物一起使用时,诊断价值得到提高,为宠物主人和兽医提供了更具体的指导方针。这项大规模研究解决了以前在小临床样本上进行的研究的局限性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/083c/11611491/dc7ca484cb3a/jvs-25-e77-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/083c/11611491/27862c08884c/jvs-25-e77-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/083c/11611491/240ad98b4d5c/jvs-25-e77-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/083c/11611491/dc7ca484cb3a/jvs-25-e77-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/083c/11611491/27862c08884c/jvs-25-e77-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/083c/11611491/240ad98b4d5c/jvs-25-e77-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/083c/11611491/dc7ca484cb3a/jvs-25-e77-g003.jpg

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本文引用的文献

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Association of Albuminuria With Chronic Kidney Disease Progression in Persons With Chronic Kidney Disease and Normoalbuminuria : A Cohort Study.白蛋白尿与慢性肾脏病和正常白蛋白尿患者慢性肾脏病进展的关系:一项队列研究。
Ann Intern Med. 2024 Apr;177(4):467-475. doi: 10.7326/M23-2814. Epub 2024 Apr 2.
2
Urinary cystatin B differentiates progressive versus stable IRIS Stage 1 chronic kidney disease in dogs.尿胱抑素 B 可区分犬进展性与稳定型 IRIS 1 期慢性肾脏病。
J Vet Intern Med. 2023 Nov-Dec;37(6):2251-2260. doi: 10.1111/jvim.16887. Epub 2023 Oct 10.
3
Establishment of a reference interval for urinary albumin-to-creatinine ratio in dogs.
建立犬尿白蛋白与肌酐比值的参考区间。
Vet Clin Pathol. 2022 Dec;51(4):585-590. doi: 10.1111/vcp.13149. Epub 2022 Jul 6.
4
Cystatin C and Neutrophil Gelatinase-Associated Lipocalin as Early Biomarkers for Chronic Kidney Disease in Dogs.胱抑素C和中性粒细胞明胶酶相关脂质运载蛋白作为犬慢性肾病的早期生物标志物
Top Companion Anim Med. 2021 Nov;45:100580. doi: 10.1016/j.tcam.2021.100580. Epub 2021 Aug 21.
5
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Res Vet Sci. 2021 Sep;138:11-18. doi: 10.1016/j.rvsc.2021.05.018. Epub 2021 May 24.
6
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Kidney Int. 2021 Jan;99(1):34-47. doi: 10.1016/j.kint.2020.10.012. Epub 2020 Oct 27.
7
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