Urinary Articles Flashcards
Clinical utility of estimation of glomerular filtration rate in dogs - McKenna 2020 (JVIM)
Retrospective (132 dogs with measured serum iohexol clearance). Group A1 - pre-azotemic CKD screening; A2 - confirm azotemic CKD; B - pre-azotemic AKI screening; C - misc. Group A1 - renal disease in 9/9 with GFR REDUCTION > 40% below baseline, 5/6 with GFR REDUCTION 30 - 40%, and 7/9 dogs with GFR reduction 20 - 30%. GFR estimation useful for diagnosis of pre-azotemic CKD.
Relationship between serum iohexol clearance, serum SDMA concentration, and serum creatinine concentration in non-azotemic dogs - McKenna 2020 (JVIM)
Prospective (119 non-azotemic dogs with serum iohexol clearance test). SDMA + Cr moderately correlated w/ GFR and each other. SDMA > 14 sensitive (90%) but nonspecific (50%) for >40% GFR reduction. Optimal cutoff for detecting GFR reduction >40% is >18 mcg/dL (sensitivity 90%, specificity 83%). In non-azotemic dogs screened for dec. renal function, SDMA > 18 (NOT >14) increases specificity without compromising sensitivity.
Comparison of the diagnostic value of symmetric dimethylarginine, cystatin C, and creatinine for detection of decreased glomerular filtration rate in dogs - Pelander 2019 (JVIM)
Prospective (97 client-owned dogs - 67 with suspect CKD + 30 healthy controls). AOC for reduced GFR - Cr 0.98, SDMA 0.96, cystatin C 0.87. Cr > 1.3 + SDMA > 14 had Se ~ 90% and Sp ~ 90% and 87% respectively. Cystatin C 0.49 mg/L had Se ~ 90% but less Sp ~ 72%. Cr + SDMA performed similarly but overall performance of cystatin C was inferior.
Diagnostic potential of simplified methods for measuring glomerular filtration rate to detect chronic kidney disease in dogs - Pocar 2019 (JVIM)
Prospective nonrandomized (17 CKD dogs, 23 non-CKD dogs). Simplified plasma iohexol clearance protocol gave reliable GFR measurements, esp. when test extended to 180 min, with strong CKD diagnostic potential (AUC 0.98). “Gray zone” of uncertain CKD guaranteed reliable diagnosis outside gray zone + IDed borderline dogs inside gray zone. Simplified GFR protocol is accurate hands on tool for CKD in dogs. Gray zone may help decision-making in management of early CKD.
Effects of low-dose meloxicam in cats with chronic kidney disease - KuKanich 2021 (JFMS)
Prospective randomized - Stage II/III CKD cats receiving low-dose meloxicam (0.02 mg/kg/d) eval. at 1, 3, and 6 months. No diff. in SBP, SDMA, BUN, Cr, GFR, or urinary biomarkers, but meloxicam cats had higher UPC at 6 months (0.33 vs 0.1) and 4 cats had to DC due to GI SFX. No decline in renal fxn but GI SFX + more proteinuric which can neg. impact CKD - recommend meloxicam is used w/ caution in CKD cats + monitor UPC.
Minimal renal pelvis dilation in cats diagnosed with benign ureteral obstruction by antegrade pyelography: a retrospective study of 82 cases (2012–2018) - Lemieux 2021 (JFMS)
Retrospective (82 cats [114 ureters] w/ benign UO on antegrade pyelography). Group 1 - <4 mm; group 2 - >4 mm. Group 1 - 30/114 (26%) with 9/114 (8%) <2 mm. Group 2 - 84/114 (74%). Stones - 80/114 (70%). Positive UC - 17/82 (21%). Azotemia - 79/82 (96%). UO may have min. RP dilation and severity of RP/U dilation very variable. Absence of significant RP dilation does NOT rule out UO in cats.
Symmetric dimethylarginine concentrations in dogs with hypothyroidism before and after treatment with levothyroxine - Di Paola 2021 (JSAP)
24 hypothyroid + 24 controls. SDMA higher in hypothyroid (13.8) and controls (11.7) at T0 - 1 hypothyroid >18 but 12 >14. Hypothyroid SDMA lower at T1 (11.83) - none >18 and 2 >14. T0 - 8/24 hypothyroid had ele. Cr > 1.4 but only one at T1. SDMA + Cr higher in hypothyroid dogs at diagnosis but majority normalized w/ treatment. SDMA rarely above upper limit when cutoff of 18 employed.
The utility of combined urine dipstick analysis and specific gravity measurement to determine feline proteinuria - Perez-Accino 2020 (JSAP)
Retrospective (121 samples). Poor agreement b/t dipstick + UPC. Dipstick > trace - Se 81% and Sp 31% and grouping by USG did not increase agreement with only slight improvement in accuracy. Dipstick + USG NOT accurate and should not be relied on.
Primary hemostatic function in dogs with acute kidney injury - McBride 2019 (JVECC)
Prospective (10 dogs IRIS Stage III+ AKI + 10 controls). PCV lower in AKI (34.7%) vs control (46.1%). PLT higher in AKI (350K vs 241K). PLT aggregometry AUC sig. lower in AKI (36.9 vs 54.9). vWF ratio sig. higher in AKI (2.2 vs 1.1) with strong correlation b/t vWF ratio + Cr. AKI dogs had dec. collagen-activated PLT aggregation and appear to have type II vWF disease-like phenotype indicated by high vWF ratio.
Measurements of echocardiographic indices and biomarkers of kidney -injury in dogs with chronic kidney disease - Hezzell 2020 (Vet Journal)
Prospective observational - 11 CKD dogs (6 Stage II, 5 Stage III) + 12 age-matched controls. CKD - sig. lower GFR + higher NT-proBNP, cystatin B, clusterin, NGAL. Echo values similar between groups. 6 dogs died during follow up (666 days) - death associated with inc. age, TP, and LV posterior wall thickness and dec. BW + PCV. Despite similar baseline echos, presence of CVRD suggested by association b/t LVPWDN + survival.
Urine cortisol-creatinine and protein-creatinine ratios in urine samples from healthy dogs collected at home and in hospital - Citron 2020 (JVIM)
Prospective non-masked - 36 healthy client-owned dogs. UCCR sig. higher in in-hospital samples but UPC not sig. different, including 8 dogs with borderline or overt proteinuria. UCCR not sig. correlated with UPC. Travel time + time in-hosp. not correlated with UCCR or UPC change. In-hosp. samples had higher UCCR but not UPC and stress not associated with proteinuria measurements.
Stability and profiling of urinary microRNAs in healthy cats and cats with pyelonephritis or other urological conditions - Jessen 2020 (JVIM)
Prospective case-control - 12 healthy, 5 PN, 13 CKD, 3 subclinical bacteriuria, 5 UO. Storage at 4C and -20C sig. lowered miRNA yield compared to -80C. PN cats had sig. upregulated miR-16 compared with controls and other urinary conditions (may be PN-specific, pathogen [E. coli]-specific, or both.
