Barton James C, German Alexander J, O'Connell Erin M
Small Animal Teaching Hospital, The University of Liverpool, Liverpool, UK.
J Vet Intern Med. 2025 Jul-Aug;39(4):e70162. doi: 10.1111/jvim.70162.
Proteinuria is associated with autoimmune diseases in humans. There is minimal evidence in the veterinary literature on proteinuria and its association with immune-mediated disease in dogs.
Renal proteinuria is common in dogs with immune-mediated disease. Dogs presenting with pyrexia or immune-mediated polyarthritis (IMPA) are more likely to have proteinuria.
One hundred and forty-four dogs with primary immune-mediated diseases.
Retrospective, observational study. Data collected included signalment, travel outside the United Kingdom, duration of clinical signs, diagnosis, urinalysis, and urine protein-creatinine ratio (UPCR). Non-proteinuric, mild proteinuria, moderate proteinuria, and severe proteinuria were defined as UPCR < 0.5; ≥ 0.5-1; ≥ 1-2; ≥ 2, respectively. Exclusion criteria included azotemia, hypoalbuminemia (< 2.0 g/dL), foreign travel, active urine sediment or positive culture, glucocorticoid therapy for greater than 24 h prior to presentation, or medication known to influence UPCR.
Sixty-seven dogs were non-proteinuric (47%; 95% confidence interval [95% CI]: 38%, 55%), 25 mildly proteinuric (17%; 95% CI: 9%, 26%), 15 moderately proteinuric (10%; 95% CI: 2%, 19%), and 37 severely proteinuric (26%; 95% CI: 17%, 34%). On multiple logistic regression analysis, female dogs (odds ratio [OR]: 3.24; 95% CI: 1.49, 7.42), individuals with pyrexia (OR: 6.59; 95% CI: 3.00, 15.37), or hemoglobinuria (OR: 27.21; 95% CI: 4.79, 516.56) were more likely to have proteinuria. There was an association between steroid-responsive meningitis-arteritis and the magnitude of proteinuria on multiple linear regression (p = 0.025); this was not confirmed on multiple logistic regression.
Proteinuria is common in dogs with immune-mediated disease and can be severe. Screening for proteinuria could be considered part of the diagnostic assessment for dogs with immune-mediated disease.
蛋白尿与人类自身免疫性疾病相关。兽医文献中关于犬类蛋白尿及其与免疫介导疾病的关联的证据极少。
免疫介导疾病的犬类中肾性蛋白尿常见。出现发热或免疫介导性多关节炎(IMPA)的犬更有可能出现蛋白尿。
144只患有原发性免疫介导疾病的犬。
回顾性观察研究。收集的数据包括特征、英国境外旅行情况、临床症状持续时间、诊断、尿液分析及尿蛋白肌酐比(UPCR)。非蛋白尿、轻度蛋白尿、中度蛋白尿和重度蛋白尿分别定义为UPCR < 0.5;≥ 0.5 - 1;≥ 1 - 2;≥ 2。排除标准包括氮质血症、低白蛋白血症(< 2.0 g/dL)、国外旅行、活动性尿沉渣或培养阳性、就诊前接受糖皮质激素治疗超过24小时或已知会影响UPCR的药物。
67只犬无蛋白尿(47%;95%置信区间[95%CI]:38%,55%),25只轻度蛋白尿(17%;95%CI:9%,26%),15只中度蛋白尿(10%;95%CI:2%,19%),37只重度蛋白尿(26%;95%CI:17%,34%)。多因素逻辑回归分析显示,雌性犬(优势比[OR]:3.24;95%CI:1.49,7.42)、发热个体(OR:6.59;95%CI:3.00,15.37)或血红蛋白尿个体(OR:27.21;95%CI:4.79,516.56)更有可能出现蛋白尿。多因素线性回归分析显示类固醇反应性脑膜炎动脉炎与蛋白尿程度之间存在关联(p = 0.025);多因素逻辑回归分析未证实这一点。
蛋白尿在免疫介导疾病的犬类中常见且可能严重。对免疫介导疾病的犬进行蛋白尿筛查可被视为诊断评估的一部分。