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超声造影在接受血液透析治疗的急性肾损伤犬中的预后价值。

Prognostic value of contrast-enhanced ultrasound in dogs with acute renal injury treated with haemodialysis.

作者信息

Puccinelli Caterina, Lippi Ilaria, Pelligra Tina, Citi Simonetta

机构信息

Department of Veterinary Sciences, University of Pisa, Pisa, Italy.

出版信息

Vet Rec. 2025 Mar 15;196(6):e4959. doi: 10.1002/vetr.4959. Epub 2025 Jan 22.

DOI:10.1002/vetr.4959
PMID:39844446
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11907752/
Abstract

BACKGROUND

It is clinically relevant to predict outcomes in dogs with acute kidney injury (AKI) treated with haemodialysis. The aim of this study was to evaluate the prognostic value of contrast-enhanced ultrasound (CEUS) and its role in discriminating between AKI and acute impairment associated with chronic kidney disease (AKI/CKD).

METHODS

Dogs diagnosed with AKI or AKI/CKD were prospectively enrolled in the study. For all dogs, CEUS was performed at admission (T0). In addition, in haemodialysis-treated dogs, it was performed after the first dialysis (T1) and 7 days (T7) and 30 days (T30) after admission.

RESULTS

A total of 41 dogs were enrolled, of which 30 were treated with haemodialysis and 11 received medical therapy. No significant difference was found between CEUS values at T0 in surviving and non-surviving patients after haemodialysis. A significant difference in cortical peak enhancement intensity (PI) values was found between T0, T1, T7 and T30, with the highest PI value at T0, a significant reduction at T1 and a progressive reduction in subsequent checks. There were no significant differences in CEUS parameters at T0 between patients with AKI and AKI/CKD.

LIMITATIONS

AKI aetiology was unknown in most cases, which limits the generalisability of the findings. Furthermore, the small sample size means that the statistical analysis is likely underpowered.

CONCLUSION

CEUS could be helpful in evaluating of the prognosis of dogs with AKI during haemodialysis.

摘要

背景

预测接受血液透析治疗的急性肾损伤（AKI）犬的预后具有临床意义。本研究的目的是评估超声造影（CEUS）的预后价值及其在鉴别AKI与慢性肾脏病相关急性损伤（AKI/CKD）中的作用。

方法

将诊断为AKI或AKI/CKD的犬前瞻性纳入研究。对所有犬在入院时（T0）进行CEUS检查。此外，对于接受血液透析治疗的犬，在首次透析后（T1）、入院后7天（T7）和30天（T30）进行CEUS检查。

结果

共纳入41只犬，其中30只接受血液透析治疗，11只接受药物治疗。血液透析后存活和未存活患者在T0时的CEUS值无显著差异。在T0、T1、T7和T30之间发现皮质峰值增强强度（PI）值有显著差异，T0时PI值最高，T1时显著降低，随后的检查中逐渐降低。AKI和AKI/CKD患者在T0时的CEUS参数无显著差异。

局限性

大多数情况下AKI的病因不明，这限制了研究结果的普遍性。此外，样本量小意味着统计分析可能效力不足。

结论

CEUS有助于评估血液透析期间AKI犬的预后。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a073/11907752/6e0684533e29/VETR-196-e4959-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a073/11907752/ea23a1b9c09e/VETR-196-e4959-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a073/11907752/199a92d7ed34/VETR-196-e4959-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a073/11907752/6e0684533e29/VETR-196-e4959-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a073/11907752/ea23a1b9c09e/VETR-196-e4959-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a073/11907752/199a92d7ed34/VETR-196-e4959-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a073/11907752/6e0684533e29/VETR-196-e4959-g002.jpg

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Int J Gen Med. 2023 Jun 3;16:2229-2236. doi: 10.2147/IJGM.S403730. eCollection 2023.
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Acute kidney injury in dogs: Etiology, clinical and clinicopathologic findings, prognostic markers, and outcome.犬急性肾损伤：病因、临床和临床病理特征、预后标志物及转归。
J Vet Intern Med. 2022 Mar;36(2):609-618. doi: 10.1111/jvim.16375. Epub 2022 Feb 1.
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Acute on chronic kidney disease in dogs: Etiology, clinical and clinicopathologic findings, prognostic markers, and survival.
犬的慢性肾脏病急性发作：病因、临床和临床病理发现、预后标志物和生存率。
J Vet Intern Med. 2020 Nov;34(6):2507-2515. doi: 10.1111/jvim.15931. Epub 2020 Oct 12.
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A pilot trial to evaluate the clinical usefulness of contrast-enhanced ultrasound in predicting renal outcomes in patients with acute kidney injury.一项评估对比增强超声在预测急性肾损伤患者肾脏结局的临床应用价值的初步试验。
PLoS One. 2020 Jun 24;15(6):e0235130. doi: 10.1371/journal.pone.0235130. eCollection 2020.
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Clinical and ultrasound variables for early diagnosis of septic acute kidney injury in bitches with pyometra.临床和超声变量在脓毒症性急性肾损伤的母犬的早期诊断。
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