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Journal of Veterinary Internal Medicine 2009Chronic kidney disease (CKD) is a common condition in geriatric cats. Diagnosis is based on the development of persistent azotemia with inadequate urine concentrating...
BACKGROUND
Chronic kidney disease (CKD) is a common condition in geriatric cats. Diagnosis is based on the development of persistent azotemia with inadequate urine concentrating ability. Biomarkers are sought for early identification.
HYPOTHESIS
Clinical variables, urine concentrating ability, proteinuria, and N-acetyl-beta-D-glucosaminidase (NAG) index will be predictive of cats at risk of developing azotemia within 12 months.
ANIMALS
Client-owned nonazotemic geriatric (>or=9 years) cats.
METHODS
Prospective longitudinal cohort study monitoring a population of healthy nonazotemic geriatric cats every 6 months until development of azotemia, death, or the study end point (September 30, 2007). Multivariable logistic regression analysis was used to assess baseline clinical, biochemical, and urinalysis variables, urine protein to creatinine ratio (UP/C), urine albumin to creatinine (UA/C) ratio, and urinary NAG index as predictors of development of azotemia.
RESULTS
One hundred and eighteen cats were recruited with a median age of 13 years. Ninety-five cats (80.5%) had been followed or reached the study end point by 12 months of which 30.5% (29/95) developed azotemia. Age, systolic blood pressure, plasma creatinine concentration, urine specific gravity, UP/C, UA/C, and NAG index were significantly associated with development of azotemia in the univariable analysis (P
CONCLUSIONS AND CLINICAL IMPORTANCE
This study demonstrates a high incidence of azotemia in a population of previously healthy geriatric cats. Proteinuria at presentation was significantly associated with development of azotemia although causal association cannot be inferred. Evaluation of NAG index offered no additional benefit.
Topics: Animals; Azotemia; Blood Pressure; Cat Diseases; Cats; Female; Logistic Models; Longitudinal Studies; Male; Multivariate Analysis; Prospective Studies; Risk Factors
PubMed: 19566846
DOI: 10.1111/j.1939-1676.2009.0339.x -
The Journal-lancet Jan 1951
Topics: Azotemia; Uremia; Urologic Diseases
PubMed: 14803867
DOI: No ID Found -
The American Journal of Tropical... Nov 1950
Topics: Azotemia; Cholera; Uremia
PubMed: 14790173
DOI: 10.4269/ajtmh.1950.s1-30.855 -
Journal of Feline Medicine and Surgery Aug 2021Hyperammonemia occurs in cats with hepatobiliary and nutritional (cobalamin and arginine deficiency) disorders, and has also been documented in four cats with renal...
OBJECTIVES
Hyperammonemia occurs in cats with hepatobiliary and nutritional (cobalamin and arginine deficiency) disorders, and has also been documented in four cats with renal azotemia. We hypothesized that in cats with renal azotemia, fasting hyperammonemia would correlate with indices of worsening kidney function, and would be independent of cobalamin, potassium, systemic inflammation or urinary tract infection (UTI) with urease-producing bacteria.
METHODS
A fasted blood sample was prospectively collected for ammonia and cobalamin analysis from 18 client-owned cats with renal azotemia (creatinine [Cr] ⩾1.6 mg/dl, urine specific gravity <1.030 or documentation of historical chronic kidney disease [CKD]). Correlations between blood ammonia and selected biochemical parameters were analyzed using Pearson's correlation coefficient.
RESULTS
Seven castrated males and 11 spayed females with a median age of 12 years (range 4-19 years) were enrolled. Ten of 18 (56%) cats presented for acute kidney injury (AKI) or acute on chronic kidney disease (AoCKD), and 8/18 (44%) presented for progressive CKD. The median Cr was 5.9 mg/dl (range 1.9-24.7 mg/dl). Hyperammonemia was documented in 4/18 (22%) cats, with a median of 95 µmol/dl (range 85-98 µmol/dl), and all four of these cats were classified as AKI/AoCKD. Blood ammonia concentrations had a significant moderate positive correlation between blood urea nitrogen (BUN) ( = 0.645, = 0.003), Cr ( = 0.578, = 0.012) and serum phosphorus ( = 0.714, = 0.0009) but not with cobalamin, potassium or white blood cell count. No cats had UTIs with urease-producing bacteria.
CONCLUSIONS AND RELEVANCE
A correlation exists between blood ammonia and BUN, Cr and phosphorus in cats with renal azotemia. Future studies are warranted in a larger population of cats to determine the true prevalence, etiology and potential therapeutic effect of medical management of hyperammonemia on long-term prognosis in cats with kidney disease.
Topics: Animals; Azotemia; Blood Urea Nitrogen; Cat Diseases; Cats; Creatinine; Female; Hyperammonemia; Male; Renal Insufficiency, Chronic
PubMed: 33215950
DOI: 10.1177/1098612X20972039 -
Journal of Veterinary Cardiology : the... Dec 2008The prevalence of renal azotemia in cats with acquired heart disease is not well documented. The aims of this study were therefore (1) to determine the prevalence of...
OBJECTIVES
The prevalence of renal azotemia in cats with acquired heart disease is not well documented. The aims of this study were therefore (1) to determine the prevalence of azotemia within a hospital population of cats with hypertrophic cardiomyopathy (HCM), and (2) to evaluate the relationship between echocardiographic variables and plasma urea and creatinine.
ANIMALS, MATERIALS AND METHODS
134 client-owned cats were retrospectively studied including 102 cats with HCM and 32 control cats. A complete physical examination, electrocardiography, systolic arterial blood pressure measurement, thoracic radiographs, and echocardiography were performed. Plasma creatinine and urea were determined in all cats. The animal was considered azotemic if plasma creatinine was >1.8 mg/dL and/or urea >65 mg/dL (i.e. BUN> 30 mg/dL).
RESULTS
The prevalence of azotemia was lower in control cats (25.0%) than in cats with HCM (58.8%) (P=0.003). No significant differences in plasma urea and creatinine were observed between the HCM and control cats. There was no effect of plasma creatinine and urea on conventional echocardiographic variables in cats with HCM.
CONCLUSIONS
Azotemia is a frequent finding in cats with HCM but is not dependent on echocardiographic variables.
Topics: Animals; Azotemia; Blood Pressure; Cardiomyopathy, Hypertrophic; Case-Control Studies; Cat Diseases; Cats; Comorbidity; Creatinine; Echocardiography; Electrocardiography; Female; Glomerular Filtration Rate; Male; Physical Examination; Prevalence; Radiography, Thoracic; Retrospective Studies; Urea
PubMed: 19027388
DOI: 10.1016/j.jvc.2008.09.002 -
Contributions To Nephrology 2010Acute kidney injury (AKI) is common in hospitalized patients and its associated mortality is high. The causes of AKI are commonly divided into 3 groups: pre-renal,...
Acute kidney injury (AKI) is common in hospitalized patients and its associated mortality is high. The causes of AKI are commonly divided into 3 groups: pre-renal, intra-renal, and post-renal. According to this paradigm, pre-renal azotemia (PRA) represents a separate entity characterized by a rapidly reversible increase in serum creatinine and urea concentration. This rapid reversibility is believed to reflect a functional reduction in glomerular filtration rate as opposed to established structural kidney injury, which leads to acute tubular necrosis (ATN). This PRA vs. ATN paradigm is well established in the medical and renal literature and widely discussed in textbooks. However, there is no consensus definition for PRA or ATN. The typical description for PRA in the literature is 'reversible increase in serum creatinine and urea concentrations', 'characterized by intact renal parenchymal function but renal hypoperfusion'. Therefore, although the term PRA implies that it is defined histopathologically, it also contains a functional aspect (transient azotemia, TA). Early recognition of PRA or ATN is considered important because PRA can be reversed with fluid resuscitation, but such treatment causes edema in lungs as well as other tissues and therefore can be harmful in ATN. However, evidence suggests that PRA cannot be diagnosed prospectively and is clinically the same as TA, that urinary analysis and biochemistries cannot distinguish PRA and ATN in septic AKI, and that ATN is histologically uncommon in septic AKI. Recent observational studies also found that TA cannot be distinguished from ATN epidemiologically and that the existence of TA is related to high hospital mortality. These findings suggest the need for specific and focused investigations directed at identifying effective treatments to decrease the incidence of TA in hospitalized patients.
Topics: Acute Disease; Azotemia; Creatinine; Fluid Therapy; Humans; Inpatients; Kidney; Kidney Function Tests; Kidney Tubules; Resuscitation; Urea
PubMed: 20427986
DOI: 10.1159/000313775 -
Obstetrics and Gynecology Oct 1964
Topics: Azotemia; Blood Urea Nitrogen; Female; Genital Diseases, Female; Humans; Hysterectomy; Kidney Function Tests; Tetracycline; Toxicology; Urea; Uremia
PubMed: 14217994
DOI: No ID Found -
Leukemia & Lymphoma Jun 2008Azotemia associated with the use of lenalidomide, a new and effective therapy for multiple myeloma, has not been reported in patients with multiple myeloma. We describe...
Azotemia associated with the use of lenalidomide, a new and effective therapy for multiple myeloma, has not been reported in patients with multiple myeloma. We describe five patients with plasma cell dyscrasias and renal insufficiency (AL amyloidosis, monoclonal gammopathy of undetermined significance with Fanconi syndrome, and multiple myeloma) treated with lenalidomide and dexamethasone who developed progressive azotemia. Onset of azotemia after initiation of lenalidomide was variable (2 weeks to several months) and was irreversible in four patients. Four patients required hemodialysis after exposure to lenalidomide; two previously were untreated for their plasma cell dyscrasia. The mechanism of azotemia is unknown, but the combination of potentially nephrotoxic paraproteins and lenalidomide, which is immunomodulatory and anti-angiogenic, may underlie this process. We conclude that azotemia is an uncommon, but serious, potential complication of lenalidomide therapy in plasma cell dyscrasias with associated renal insufficiency. We advise careful monitoring of renal function after initiation of lenalidomide in this setting.
Topics: Acute Kidney Injury; Adult; Aged; Antineoplastic Combined Chemotherapy Protocols; Azotemia; Dexamethasone; Disease Progression; Female; Humans; Lenalidomide; Male; Middle Aged; Multiple Myeloma; Paraproteinemias; Paraproteins; Renal Dialysis; Thalidomide
PubMed: 18452093
DOI: 10.1080/10428190802023707 -
The American Journal of the Medical... May 1946
Topics: Azotemia; Blood; Eating; Gastrointestinal Hemorrhage; Hemorrhage; Humans; Nitrogen
PubMed: 21026494
DOI: No ID Found -
Renal azotemia and associated clinical and laboratory findings in dogs with Babesia rossi infection.Veterinary Parasitology Aug 2018The occurrence of acute kidney injury in canine babesiosis is not well documented. Furthermore, interpretation of urine specific gravity (USG) to assess renal...
The occurrence of acute kidney injury in canine babesiosis is not well documented. Furthermore, interpretation of urine specific gravity (USG) to assess renal concentrating ability is hampered by the frequent presence of hemoglobinuria in this disease. This cross-sectional study aimed to test the hypothesis that renal azotemia (RA) is underdiagnosed according to current canine babesiosis literature by determining its occurrence at presentation, using urine osmolality instead of USG to measure urinary concentration. The second objective was to examine potential associations between the presence of RA and selected clinical and laboratory variables at presentation. Medical records available from 3 previously performed prospective data collections were reviewed retrospectively. Client-owned dogs that were diagnosed with babesiosis caused by Babesia rossi, were included if a complete blood count, biochemistry profile, and urinalysis was performed at admission. Urine osmolality was measured to identify dogs with RA. Differences between dogs with RA and dogs without RA were assessed by nonparametric statistics. One hundred and fifty-two dogs were included, of which 26 (17%) were azotemic at admission. The occurrence of RA was 14% (21/152), hence 81% (21/26) of all azotemic dogs were diagnosed with RA. In contrast, when diagnosis of RA was based on an admission USG < 1.030, only 23% (6/26) of the azotemic dogs would have been considered to have RA. Several signalment and clinicopathological findings were found to be associated with the presence of RA, including older age, and the presence of collapse, hypoglycemia, hyperphosphatemia, cerebral babesiosis, and acute respiratory distress syndrome. Lastly, survival at discharge was significantly lower in dogs diagnosed with RA at presentation. Our results clarified that RA is more common than previously reported in B. rossi. This study also demonstrated that USG determination is not a reliable method to evaluate renal concentrating ability in azotemic dogs with babesiosis. Thus, if available, urine osmolality should be part of the diagnostic work-up of dogs infected with B. rossi to avoid misclassification of dogs with RA as having prerenal azotemia. If urine osmolality cannot be measured, clinicians should realize that most azotemic dogs with B. rossi infection have RA.
Topics: Animals; Azotemia; Babesia; Babesiosis; Blood Cell Count; Clinical Laboratory Techniques; Cross-Sectional Studies; Dog Diseases; Dogs; Kidney; Kidney Diseases; Osmolar Concentration; Prospective Studies; Retrospective Studies; Urinalysis
PubMed: 30197009
DOI: 10.1016/j.vetpar.2018.07.012