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Acta Veterinaria Scandinavica Mar 2022Ethylene glycol (EG) (antifreeze) toxicosis has mostly been reported in dogs and cats, while reports on EG toxicosis in cattle are sparse. We report EG toxicosis in 25...
BACKGROUND
Ethylene glycol (EG) (antifreeze) toxicosis has mostly been reported in dogs and cats, while reports on EG toxicosis in cattle are sparse. We report EG toxicosis in 25 milk-fed calves associated with a leak in the cooling pipes in a milk taxi. The milk taxi was connected to a geothermal heating system in which EG was used as antifreeze.
CASE PRESENTATION
Although the assistant responsible for feeding milk to the calves observed a few blue-colored droplets of liquid on the surface of the milk in the milk taxi and suspected EG contamination, the milk was fed to the calves. Within hours, the calves became depressed and some died within the next 2 days. Necropsy and histopathology revealed widespread severe acute renal tubular necrosis with numerous birefringent crystals in the tubular lumen. Biochemical analysis of serum showed severe damage to the kidneys (marked azotemia) and hypochloremia, hyponatremia and hyperkalemia; findings consisting with metabolic acidosis. After feeding the calves, the assistant inspected the milk taxi and found a leaking cooling pipe.
CONCLUSIONS
The suspected EG toxicosis was confirmed by the observation of renal tubular necrosis, numerous intratubular crystals, and metabolic acidosis. EG toxicosis due to leaking pipes connected to a geothermal heating system has not been reported previously. Alternative antifreeze products that are less toxic than EG are recommended for use if there is a risk of contamination of human and animal foodstuffs in case of a leak in the system.
Topics: Animals; Autopsy; Cat Diseases; Cats; Cattle; Cattle Diseases; Dog Diseases; Dogs; Ethylene Glycol; Milk
PubMed: 35331297
DOI: 10.1186/s13028-022-00626-1 -
Clinical Journal of the American... Jun 2022
Topics: Acute Kidney Injury; Humans; Kidney Function Tests; Sodium
PubMed: 35613884
DOI: 10.2215/CJN.04750422 -
Journal of Feline Medicine and Surgery Dec 2020The aim of this study was to describe the causes, clinicopathologic features and outcomes of feline protein-losing nephropathy (proteinuria secondary to glomerular...
OBJECTIVES
The aim of this study was to describe the causes, clinicopathologic features and outcomes of feline protein-losing nephropathy (proteinuria secondary to glomerular disease [PLN]).
METHODS
Kidney biopsy/necropsy samples from proteinuric cats submitted to the International Veterinary Renal Pathology Service were retrospectively reviewed. Diagnoses based on histopathology were categorized by primary disease compartment. Clinicopathologic variables at diagnosis, development of hypoalbuminemia, anemia, hypertension, azotemia and effusion/edema, and survival were compared between cats with immune-complex glomerulonephritis (ICGN) and other causes of PLN.
RESULTS
Fifty-eight percent (n = 31/53) of proteinuric cats had ICGN and 74% (n = 31/42) of cats with PLN had ICGN. Cats with glomerular diseases other than ICGN had a higher median urine protein:creatinine ratio than ICGN cats (14.5 vs 6.5; <0.001). Onset of PLN occurred at a young age; median age at diagnosis was 3.5 years in ICGN cats vs 1.3 years in cats with other glomerular diseases ( = 0.026). Development of complications such as hypoalbuminemia, anemia, hypertension, azotemia and effusion/edema were common, regardless of the cause of PLN, and were not different between ICGN and cats with other glomerular diseases. Male cats were over-represented in the ICGN group ( = 0.003). Median survival time (MST) for all cats with PLN was 94 days (range 3-1848 days). Survival was not different between cats with ICGN and cats with other glomerular diseases. MST in ICGN cats that developed effusion was shorter (94 days) than cats that did not (700 days; = 0.035). MST in IGCN cats that received immunosuppressive medications was longer (244 days) than cats that did not (17 days, = 0.039).
CONCLUSIONS AND RELEVANCE
Taken together, these data suggest that clinical suspicion for glomerular proteinuria should increase in young, male cats with higher degrees of proteinuria, and immune-mediated disease is common. Further studies are needed to determine the effect of immunosuppression on morbidity and mortality in cats with ICGN.
Topics: Animals; Cat Diseases; Cats; Female; Kidney; Kidney Diseases; Kidney Function Tests; Male; Proteinuria; Retrospective Studies
PubMed: 32456516
DOI: 10.1177/1098612X20921056 -
Journal of the American Society of... Sep 2011Up to 30% of hospitalized critically ill patients may have a rise in serum creatinine concentration. In addition to history and physical examination, there is diagnostic... (Review)
Review
Up to 30% of hospitalized critically ill patients may have a rise in serum creatinine concentration. In addition to history and physical examination, there is diagnostic value in assessing urinary electrolytes, solute excretion, and urine flow in these patients. The correct interpretation of these urinary parameters can avoid unnecessary volume overload and mechanical ventilation, risk factors for increased mortality in patients with rising serum creatinine. The present article also discusses the role of arterial underfilling in causing prerenal azotemia in the presence of an increase in total body sodium and extracellular fluid expansion. As with extracellular fluid volume depletion, arterial underfilling secondary to impaired cardiac function or primary arterial vasodilation can delay or prevent recovery from ischemic or toxic acute tubular necrosis. The present brief review discusses the various aspects of the correct interpretation of urinary electrolytes, solute excretion, and urine flow in the setting of a rising serum creatinine concentration.
Topics: Azotemia; Chlorides; Creatinine; Humans; Osmolar Concentration; Sodium; Urea; Urine
PubMed: 21852582
DOI: 10.1681/ASN.2010121289 -
The Indian Journal of Medical Research Feb 2010The prevalence of sleep-disordered breathing (SDB) in the advanced chronic kidney disease (CKD) patient population has been estimated to be more than 50 per cent. SDB is... (Review)
Review
The prevalence of sleep-disordered breathing (SDB) in the advanced chronic kidney disease (CKD) patient population has been estimated to be more than 50 per cent. SDB is associated with episodic upper airway obstruction or cessation of breathing during sleep leading to repetitive episodes of hypoxaemia, hypercapnia, and sleep fragmentation, activation of the sympathetic nervous system, endothelial dysfunction, oxidative stress, and inflammation. Clinical consequences of this disorder may include excessive daytime sleepiness, depressed mood, cognitive impairment, hypertension, as well as increased risk for cardiovascular disease and metabolic dysregulation. SDB may also contribute substantially to the daytime sleepiness, poor quality of life, and high rate of cardiovascular disease in CKD patients. Although the causal links between CKD and SDB remain speculative, there are multiple factors related to fluid overload and azotaemia that may contribute to the increased propensity to SDB. Renal transplantation, nocturnal automated peritoneal dialysis and nocturnal haemodialysis have been found to be associated with a reduction in the severity of SDB when compared to conventional forms of dialysis. Nocturnal dialysis modalities may facilitate further understanding of the pathophysiology of SDB as well as provide therapeutic alternatives for patients with both kidney failure and SDB. SDB is an important but often overlooked public health problem in the CKD patient population. Early diagnosis and treatment of SDB may provide better quality of life and attenuate the cardiovascular risk of morbidity and mortality in these patients.
Topics: Cardiovascular Diseases; Comorbidity; Continuous Positive Airway Pressure; Glomerular Filtration Rate; Humans; Kidney; Kidney Failure, Chronic; Kidney Transplantation; Prevalence; Renal Dialysis; Respiration; Risk; Sleep Apnea Syndromes; Treatment Outcome
PubMed: 20308753
DOI: No ID Found -
Nature Medicine Apr 2017African Americans have a heightened risk of developing chronic and end-stage kidney disease, an association that is largely attributed to two common genetic variants,...
African Americans have a heightened risk of developing chronic and end-stage kidney disease, an association that is largely attributed to two common genetic variants, termed G1 and G2, in the APOL1 gene. Direct evidence demonstrating that these APOL1 risk alleles are pathogenic is still lacking because the APOL1 gene is present in only some primates and humans; thus it has been challenging to demonstrate experimental proof of causality of these risk alleles for renal disease. Here we generated mice with podocyte-specific inducible expression of the APOL1 reference allele (termed G0) or each of the risk-conferring alleles (G1 or G2). We show that mice with podocyte-specific expression of either APOL1 risk allele, but not of the G0 allele, develop functional (albuminuria and azotemia), structural (foot-process effacement and glomerulosclerosis) and molecular (gene-expression) changes that closely resemble human kidney disease. Disease development was cell-type specific and likely reversible, and the severity correlated with the level of expression of the risk allele. We further found that expression of the risk-variant APOL1 alleles interferes with endosomal trafficking and blocks autophagic flux, which ultimately leads to inflammatory-mediated podocyte death and glomerular scarring. In summary, this is the first demonstration that the expression of APOL1 risk alleles is causal for altered podocyte function and glomerular disease in vivo.
Topics: Albuminuria; Alleles; Animals; Apolipoprotein L1; Apolipoproteins; Autophagy; Azotemia; Blotting, Western; Endocytosis; Endosomes; Fluorescent Antibody Technique; Genetic Predisposition to Disease; Genetic Variation; Glomerulosclerosis, Focal Segmental; HEK293 Cells; HeLa Cells; Humans; Immunohistochemistry; In Situ Nick-End Labeling; Kidney Glomerulus; Lipoproteins, HDL; Mice; Mice, Transgenic; Microscopy, Electron; Podocytes; Renal Insufficiency, Chronic
PubMed: 28218918
DOI: 10.1038/nm.4287 -
Nutrients Apr 2016Critically ill older patients with sarcopenia experience greater morbidity and mortality than younger patients. It is anticipated that unabated protein catabolism would... (Review)
Review
Critically ill older patients with sarcopenia experience greater morbidity and mortality than younger patients. It is anticipated that unabated protein catabolism would be detrimental for the critically ill older patient. Healthy older subjects experience a diminished response to protein supplementation when compared to their younger counterparts, but this anabolic resistance can be overcome by increasing protein intake. Preliminary evidence suggests that older patients may respond differently to protein intake than younger patients during critical illness as well. If sufficient protein intake is given, older patients can achieve a similar nitrogen accretion response as younger patients even during critical illness. However, there is concern among some clinicians that increasing protein intake in older patients during critical illness may lead to azotemia due to decreased renal functional reserve which may augment the propensity towards worsened renal function and worsened clinical outcomes. Current evidence regarding protein requirements, nitrogen balance, ureagenesis, and clinical outcomes during nutritional therapy for critically ill older patients is reviewed.
Topics: Aged; Critical Illness; Dietary Proteins; Elder Nutritional Physiological Phenomena; Humans; Nitrogen
PubMed: 27096868
DOI: 10.3390/nu8040226 -
Journal of Feline Medicine and Surgery Aug 2020The aims of this study were to determine the side effect frequency and serum and urine drug concentrations of amoxicillin-clavulanic acid in cats with and without...
OBJECTIVES
The aims of this study were to determine the side effect frequency and serum and urine drug concentrations of amoxicillin-clavulanic acid in cats with and without azotemic chronic kidney disease (azCKD).
METHODS
Owners whose cats had been prescribed amoxicillin-clavulanic acid completed a survey regarding the occurrence and type of side effects, and whether treatment was altered as a result. Cats were defined as azCKD (serum creatinine concentration >2.0 mg/dl, urine specific gravity [USG] <1.035 with a clinical diagnosis of chronic kidney disease) and without azCKD (serum creatinine concentration <2.0 mg/dl). Data were assessed with Fisher's exact test. Serum and urine samples were obtained from client-owned cats with azCKD (n = 6) and without azCKD (n = 6, serum creatinine concentration <1.8 mg/dl, USG >1.035) that were receiving amoxicillin-clavulanic acid. Amoxicillin and clavulanic acid were measured with liquid chromatography coupled to tandem mass spectrometry and compared between groups with a Mann-Whitney test. Correlation between serum creatinine and drug concentrations in urine and serum was determined using Spearman's rank test.
RESULTS
Sixty-one surveys were returned (11 azCKD cats and 50 without azCKD cats). No significant difference in the presence of side effects or type of side effects was seen between groups; however, significantly more azCKD cats had more than one side effect ( = 0.02). More owners of azCKD cats reported that an alteration in treatment plan was necessitated by side effects (55% vs 12%; = 0.008). Urine amoxicillin was significantly lower in cats with azCKD ( = 0.01) and serum amoxicillin trended toward significance ( = 0.07). Serum amoxicillin concentration was positively correlated with serum creatinine ( = 0.02; = 0.62) and urine amoxicillin concentration was negatively correlated with serum creatinine ( = 0.01; = -0.65).
CONCLUSIONS AND RELEVANCE
The data suggest that cats with azCKD have altered pharmacokinetics of amoxicillin, which may contribute to an increased incidence of multiple side effects.
Topics: Amoxicillin-Potassium Clavulanate Combination; Animals; Anti-Bacterial Agents; Azotemia; Cat Diseases; Cats; Female; Male; Pilot Projects
PubMed: 31660773
DOI: 10.1177/1098612X19881537 -
Journal of Feline Medicine and Surgery Feb 2021Meloxicam therapy may benefit cats with degenerative joint disease, and retrospective studies suggest it could slow kidney disease progression and increase survival....
OBJECTIVES
Meloxicam therapy may benefit cats with degenerative joint disease, and retrospective studies suggest it could slow kidney disease progression and increase survival. This study aimed to prospectively evaluate the renal effects of low-dose meloxicam treatment (0.02 mg/kg/day) over 6 months in cats with chronic kidney disease (CKD).
METHODS
Twenty-one cats with stable International Renal Interest Society stage 2 or 3 CKD were recruited and randomized to placebo or meloxicam groups. Cats were evaluated at baseline and at 1, 3 and 6 months, including blood pressure, chemistry, symmetric dimethylarginine (SDMA), glomerular filtration rate (GFR), urinalysis, urine protein:creatinine ratio (UPC), urine transforming growth factor-beta (β):creatinine ratio, urine clusterin, urine cystatin B and serum inosine.
RESULTS
No statistical difference was observed in systolic blood pressure, blood urea nitrogen, creatinine, SDMA, GFR, urine transforming growth factor-β:creatinine ratio, urine clusterin, urine cystatin B or serum inosine in cats receiving meloxicam vs placebo. Mean UPC was greater in the meloxicam group (0.33) than the placebo group (0.1) at 6 months ( = 0.006). Four cats had meloxicam discontinued owing to potential (mainly gastrointestinal) adverse effects.
CONCLUSIONS AND RELEVANCE
No decline in renal excretory function was observed when meloxicam was administered to cats with CKD. However, gastrointestinal adverse effects were observed, and cats that received meloxicam had greater proteinuria at 6 months than cats that received placebo. As proteinuria is associated with negative outcomes (progression of azotemia and hypertension) in cats with CKD, this finding suggests that meloxicam should be used with caution in cats with CKD and UPC monitored. Until further research is available, clinicians should weigh the risk of potential increased proteinuria against quality of life benefits when considering meloxicam for analgesia in cats with renal disease.
Topics: Animals; Cat Diseases; Cats; Glomerular Filtration Rate; Meloxicam; Quality of Life; Renal Insufficiency, Chronic; Retrospective Studies
PubMed: 32594827
DOI: 10.1177/1098612X20935750 -
Critical Care (London, England) Feb 2013Urinary sodium (NaU) is one of the oldest parameters used in the evaluation of azotemia and oliguria. Over the past years, however, it has progressively been considered... (Review)
Review
Urinary sodium (NaU) is one of the oldest parameters used in the evaluation of azotemia and oliguria. Over the past years, however, it has progressively been considered as obsolete and useless, especially in sepsis. It is common sense that NaU frequently does not correlate well with global renal blood flow. If intrarenal microcirculatory changes are more important in acute kidney injury (AKI) than changes in global renal blood flow, we speculate that decreases in NaU may be viewed as a possible marker of microcirculatory impairment in the kidneys. Recent findings by our group (some not yet published) in which sodium retentive capacity is preserved until advanced stages of AKI and the observation of decreases in NaU preceding increases in creatinine bring us to conclude that the new paradigm of abolishing NaU consideration from daily approaches to managing patients at risk for AKI must be reevaluated.
Topics: Acute Kidney Injury; Biomarkers; Disease Management; Humans; Sodium
PubMed: 23384365
DOI: 10.1186/cc11926