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Kaenkangploo D, Kampa N, Jitpean S, Seesupa S, Yongvanit K. Assessment of glomerular filtration rate measurement in dogs using dynamic contrast CT compared to serum iohexol clearance. Vet Radiol Ultrasound 2021; 63:38-46. [PMID: 34637569 DOI: 10.1111/vru.13024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Revised: 07/20/2021] [Accepted: 07/21/2021] [Indexed: 11/30/2022] Open
Abstract
Dynamic contrast CT with Patlak plot analysis can be used to determine the glomerular filtration rate (GFR). However, several studies have shown different GFR values and they are most likely less than the values by the standard techniques. The purpose of this prospective, experimental, and method comparison study was to evaluate the GFR using a CT technique (CT-GFR) in 12 healthy dogs compared to serum iohexol clearance (SIC-GFR). All dogs were anesthetized and placed in the right lateral recumbency position and the caudal part was lifted inside the CT gantry. A single-slice dynamic CT of the aorta and both kidneys was scanned sequentially every 2 s for 2 min after a bolus injection (3 mL/s) of iohexol (300 mg/kg). Time attenuation curves (TAC) were constructed and the GFR per volume of kidney was calculated using the Patlak plot analysis method based on 30-120 s time intervals, and results were compared to global GFR from SIC that was determined with eight blood samples for up to 240 min. The CT-GFR value (1.85 ± 0.48 mL/min/kg) was significantly less than the SIC-GFR value (3.40 ± 0.80 mL/min/kg; P < .05). The CT-GFR was correlated with SIC-GFR by the coefficient of correlation (r) at 0.61 (P = .046). In conclusion, the CT-GFR underestimated SIC-GFR and should be used carefully. We suggest that the GFR should be calculated using the equation derived from linear regression between CT-GFR and the standard GFR method. With its own particular parameters, each institute should have its own prediction equation.
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Affiliation(s)
- Duangdaun Kaenkangploo
- Division of Surgery, Faculty of Veterinary Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Naruepon Kampa
- Division of Surgery, Faculty of Veterinary Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Supranee Jitpean
- Division of Surgery, Faculty of Veterinary Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Suvaluk Seesupa
- Division of Surgery, Faculty of Veterinary Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Karn Yongvanit
- Veterinary Teaching Hospital, Khon Kaen University, Khon Kaen, Thailand
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McKenna M, Pelligand L, Elliott J, Cotter D, Jepson R. Relationship between serum iohexol clearance, serum SDMA concentration, and serum creatinine concentration in non-azotemic dogs. J Vet Intern Med 2019; 34:186-194. [PMID: 31725186 PMCID: PMC6979102 DOI: 10.1111/jvim.15659] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2019] [Accepted: 10/23/2019] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND Serum creatinine and symmetric dimethylarginine (SDMA) are used as surrogate markers of glomerular filtration rate (GFR) in clinical practice. Data pertaining to the correlations between GFR, SDMA, and serum creatinine in client-owned dogs are limited. OBJECTIVES To describe the relationship between GFR, SDMA, and serum creatinine in a population of client-owned dogs, and to compare clinical utility of SDMA to GFR estimation for detecting pre-azotemic chronic kidney disease. ANIMALS Medical records of 119 dogs that had GFR estimation performed via serum iohexol clearance between 2012 and 2017. METHODS Prospective study using archived samples. GFR, SDMA, and serum creatinine results were reviewed and submitting practices contacted for outcome data. All dogs included in the study population were non-azotemic. Correlations between GFR, SDMA, and serum creatinine were determined by regression analysis. Sensitivity, specificity, and positive and negative likelihood ratios of different cutoffs for SDMA and serum creatinine for detecting decreased GFR were calculated, using a 95% confidence interval. RESULTS Serum creatinine and SDMA were moderately correlated with GFR (R2 = 0.52 and 0.27, respectively, P < .0001) and with each other (R2 = 0.33, P < .0001). SDMA >14 μg/dL was sensitive (90%) but nonspecific (50%) for detecting a ≥40% decrease in GFR. Optimal SDMA concentration cutoff for detecting a ≥40% GFR decrease was >18 μg/dL (sensitivity 90%, specificity 83%). CONCLUSIONS AND CLINICAL IMPORTANCE In non-azotemic dogs being screened for decreased renal function, using a cutoff of >18 μg/dL rather than >14 μg/dL increases the specificity of SDMA, without compromising sensitivity.
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Affiliation(s)
- Myles McKenna
- Department of Clinical Science and Services, Royal Veterinary College, London, United Kingdom
| | - Ludovic Pelligand
- Department of Clinical Science and Services, Royal Veterinary College, London, United Kingdom
| | - Jonathan Elliott
- Department of Comparative Biomedical Sciences, Royal Veterinary College, London, United Kingdom
| | - Daniel Cotter
- Department of Clinical Science and Services, Royal Veterinary College, London, United Kingdom
| | - Rosanne Jepson
- Department of Clinical Science and Services, Royal Veterinary College, London, United Kingdom
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McKenna M, Pelligand L, Elliott J, Walker D, Jepson R. Clinical utility of estimation of glomerular filtration rate in dogs. J Vet Intern Med 2019; 34:195-205. [PMID: 31373414 PMCID: PMC6979109 DOI: 10.1111/jvim.15561] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2019] [Accepted: 07/01/2019] [Indexed: 01/20/2023] Open
Abstract
Background Glomerular filtration rate (GFR) estimation is the gold standard for assessment of renal function, although the clinical utility of this test is unclear. Objectives To describe the clinical utility of GFR estimation in dogs. Animals Medical records of 132 dogs that had serum iohexol clearance measured between 2012 and 2017. Methods Iohexol clearance and clinical records were reviewed and submitting practices contacted to obtain outcome data. Dogs were classified into 4 groups based on the reason for performing GFR estimation: A1 (screening for pre‐azotemic chronic kidney disease [CKD], n = 105), A2 (confirmation of azotemic CKD, n = 3), B (screening for pre‐azotemic acute kidney injury, n = 19), and C (miscellaneous causes, n = 5). Descriptive review of the clinical utility of GFR estimation is provided. Results For dogs in Group A1, renal disease was diagnosed in 9/9 dogs with a GFR ≥40% decreased below the mean GFR of their body weight category, in 5/6 dogs with a ≥30% but <40% reduction in GFR and in 7/9 dogs with a ≥20% but <30% reduction in GFR. Conclusions and Clinical Importance Glomerular filtration rate estimation is useful for the diagnosis of CKD before the onset of azotemia.
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Affiliation(s)
- Myles McKenna
- Department of Clinical Science and Services, Royal Veterinary College, London, United Kingdom
| | - Ludovic Pelligand
- Department of Clinical Science and Services, Royal Veterinary College, London, United Kingdom
| | - Jonathan Elliott
- Department of Comparative Biomedical Sciences, Royal Veterinary College, London, United Kingdom
| | - David Walker
- Anderson Moores Veterinary Specialists, Winchester, United Kingdom
| | - Rosanne Jepson
- Department of Clinical Science and Services, Royal Veterinary College, London, United Kingdom
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Lippi I, Perondi F, Petrini D, La Fortuna MC, Luci G, Intorre L, Guidi G, Meucci V. Evaluation of glomerular filtration rate estimation by means of plasma clearance of iohexol in domestic rabbits ( Oryctolagus cuniculus). Am J Vet Res 2019; 80:525-532. [PMID: 31140848 DOI: 10.2460/ajvr.80.6.525] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To evaluate glomerular filtration rate (GFR) estimation by means of plasma clearance of iohexol (IOX) in domestic rabbits and to assess accuracy of limited-sampling models for GFR estimation. ANIMALS 6 healthy domestic rabbits (Oryctolagus cuniculus). PROCEDURES Each rabbit received IOX (64.7 mg/kg [0.1 mL/kg], IV), and blood samples were collected at predetermined times before and after administration. Plasma IOX concentration was determined by high-performance liquid chromatography. The pharmacokinetics of IOX was determined by a noncompartmental method. For each rabbit, plasma clearance of IOX was determined by dividing the total IOX dose administered by the area under the concentration-time curve indexed to the subject's body weight. The GFR estimated from the plasma IOX concentration at 6 sampling times (referent model) was compared with that estimated from the plasma IOX concentration at 5 (model A), 4 (model B), and 3 (models C, D, and E) sampling times (limited-sampling models). RESULTS Mean ± SD GFR was 4.41 ± 1.10 mL/min/kg for the referent model and did not differ significantly from the GFR estimated by any of the limited-sampling models. The GFR bias magnitude relative to the referent model was smallest for model D in which GFR was estimated from plasma IOX concentrations at 5, 15, and 90 minutes after IOX administration. CONCLUSIONS AND CLINICAL RELEVANCE Results suggested that plasma clearance of IOX was a safe, reliable, accurate, and clinically feasible method to estimate GFR in domestic rabbits. Further research is necessary to refine the method.
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Monteiro BP, Lambert C, Bianchi E, Genevois JP, Soldani G, Troncy E. Safety and efficacy of reduced dosage ketoprofen with or without tramadol for long-term treatment of osteoarthritis in dogs: a randomized clinical trial. BMC Vet Res 2019; 15:213. [PMID: 31238912 PMCID: PMC6591828 DOI: 10.1186/s12917-019-1960-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2018] [Accepted: 06/13/2019] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND This study aimed to evaluate the safety and efficacy of reduced-dosage ketoprofen with or without tramadol in dogs. Five healthy dogs receiving standard-dosage ketoprofen (2 mg/kg SC, then 1 mg/kg PO daily) comprised Group A. Twenty dogs with osteoarthritis were randomized to receive reduced-dosage ketoprofen (0.5 mg/kg SC once; 0.25 mg/kg PO daily) alone (Group B) or in combination with tramadol (5 mg/kg/day PO) (Group C). Treatments were administered for 28 days. Platelet aggregation time (PAT), gastrointestinal (GI) endoscopy and glomerular filtration rate (GFR) were performed up to 60 days after treatment initiation. Pain was scored using a validated clinical metrology instrument up to D120. Data were analyzed with general linear mixed model for repeated measures (α = 0.05). RESULTS PAT was not different between groups but was increased with time for all groups. GI lesion scores were higher in Group A than Groups B and C (day 28; P = 0.005) and were increased with time for Group A (P = 0.005). GFR was lower in Group A than Groups B and C (day 28; P < 0.01) and were decreased with time for group A (P < 0.001). Standard-dosage ketoprofen administration resulted in clinically relevant adverse effects. Pain score decreased in both treated groups (B and C) from D0 to D28. Need of rescue analgesia from D29 to D120 was higher in Group B than in Group C (P = 0.039). CONCLUSIONS The long-term safety profile of reduced-dosage ketoprofen is similar whether the drug is administered alone or in combination with tramadol to dogs with osteoarthritis. Analgesic efficacy of the combination looks attractive.
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Affiliation(s)
- Beatriz P Monteiro
- Department of Biomedical Sciences, GREPAQ (Groupe de recherche en pharmacologie animale du Québec), Faculty of Veterinary Medicine - Université de Montréal, 3200 Sicotte Street, Saint-Hyacinthe, QC, J2S 2M2, Canada
| | - Cedric Lambert
- Department of Companion Animals, Vet-Agro Sup, Lyon, France
| | - Elena Bianchi
- Department of Pharmacology, College of Veterinary Medicine, University of Pisa, Pisa, Italy
| | | | - Giulio Soldani
- Department of Pharmacology, College of Veterinary Medicine, University of Pisa, Pisa, Italy
| | - Eric Troncy
- Department of Biomedical Sciences, GREPAQ (Groupe de recherche en pharmacologie animale du Québec), Faculty of Veterinary Medicine - Université de Montréal, 3200 Sicotte Street, Saint-Hyacinthe, QC, J2S 2M2, Canada.
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Wallimann M, Richter H, Sieber-Ruckstuhl NS, Blaser A, Gent TC, Krämer SD, Santner G, Kircher PR, Dennler M. Influence of injection protocol and measurement technique on computed tomographic assessment of glomerular filtration rate in healthy Beagles. Am J Vet Res 2018; 79:1298-1305. [PMID: 30457905 DOI: 10.2460/ajvr.79.12.1298] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To compare values of CT-derived glomerular filtration rate (GFR) determined by 3 contrast-medium injection protocols and 4 measurement techniques in healthy Beagles. ANIMALS 9 healthy Beagles (mean ± SD weight, 13.2 ± 1.6 kg). PROCEDURES Each dog underwent 3 iohexol-injection protocols (700 mg of iodine/kg administered at a constant rate over 20 seconds, 700 mg of iodine/kg administered following an exponentially decelerated injection over 20 seconds, and 350 mg of iodine/kg at a constant rate over 10 seconds) during dynamic, whole renal-volume CT in randomized order with an interval of ≥ 7 days between experiments. Values of GFR determined from Patlak plots derived by use of 4 measurement techniques (standard transverse section, optimized transverse section, dorsal reconstruction, and volume calculation techniques) were compared. RESULTS The measurement technique influenced the mean ± SD GFR results (standard transverse section technique, 2.49 ± 0.54 mL/kg/min; optimized transverse section technique, 2.72 ± 0.52 mL/kg/min; dorsal reconstruction technique, 3.00 ± 0.60 mL/kg/min, and volume calculation technique, 2.48 ± 0.51 mL/kg/min). The lower iodine dose resulted in a significantly higher GFR value (3.00 ± 0.65 mL/kg/min), compared with that achieved with either higher dose administration (constant rate injection, 2.54 ± 0.45 mL/kg/min and exponentially decelerated injection, 2.47 ± 0.48 mL/kg/min). CONCLUSIONS AND CLINICAL RELEVANCE In healthy Beagles, the CT-derived GFR measurements obtained after injection of a full dose of contrast medium were reduced, compared with measurements obtained after injection of a half dose. This finding is important with regard to potential nephrotoxicosis in dogs with impaired renal function and for GFR measurement with CT-contrast medium protocols.
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Landoni MF, Albarellos GA. Pharmacokinetics of levofloxacin after single intravenous, oral and subcutaneous administration to dogs. J Vet Pharmacol Ther 2018; 42:171-178. [DOI: 10.1111/jvp.12726] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2017] [Revised: 09/04/2018] [Accepted: 09/16/2018] [Indexed: 11/28/2022]
Affiliation(s)
- Maria Fabiana Landoni
- Cátedra de Farmacología; Facultad de Ciencias Veterinarias; CONICET; Universidad Nacional de La Plata; La Plata Buenos Aires Argentina
| | - Gabriela Alejandra Albarellos
- Cátedra de Farmacología; Facultad de Ciencias Veterinarias; Universidad de Buenos Aires; Buenos Aires Buenos Aires Argentina
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Reynolds BS, Massal MR, Nguyen P, Grégoire LL, Périgaud AE, Concordet D, Biourge V, Lefebvre HP. Plasma exogenous creatinine clearance in clinically healthy cats: comparison with urinary exogenous creatinine clearance, tentative reference intervals and indexation to bodyweight. Vet J 2014; 202:157-65. [PMID: 25193408 DOI: 10.1016/j.tvjl.2014.07.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2013] [Revised: 04/30/2014] [Accepted: 07/26/2014] [Indexed: 10/25/2022]
Abstract
Glomerular filtration rate (GFR) is considered to be the best indicator of overall kidney function. The major objectives of this study were to compare plasma exogenous creatinine clearance (PECC) with a reference method, to establish reference intervals (RIs) for PECC and to assess the effects of indexation of GFR to bodyweight (BW) in cats. PECC was compared with urinary clearance of exogenous creatinine (UECC) in six clinically healthy domestic shorthair cats (experiment 1). Tentative RIs were determined according to current guidelines and the effects of indexation to BW and of covariables on GFR were assessed in 43 clinically healthy cats of various breeds (experiment 2). PECC was 15% higher than UECC (P <0.01), but the two estimates were strongly correlated (r(2)=0.97, P = 0.001). RIs for PECC were 6.4-21.3 mL/min or 1.2-4.9 mL/min/kg. The absolute (i.e. non-indexed) GFR value was not dependent on BW. Thus, indexation of GFR to BW in cats would not standardize the GFR value, but could introduce bias in clinical interpretation. Significant effects of breed, plasma protein concentration and plasma albumin concentration on GFR were demonstrated. Plasma concentrations of urea and creatinine, when assessed separately, were also weakly correlated with GFR in healthy cats. These combined findings contribute to a better understanding of renal function assessment in cats.
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Affiliation(s)
- B S Reynolds
- Unité de Recherche Clinique, Université de Toulouse, INP, Ecole Nationale Vétérinaire de Toulouse, F-31076 cedex 03 Toulouse, France.
| | - M R Massal
- Unité de Recherche Clinique, Université de Toulouse, INP, Ecole Nationale Vétérinaire de Toulouse, F-31076 cedex 03 Toulouse, France
| | - P Nguyen
- Unité de Nutrition et d'Endocrinologie, Oniris, F-44307, Nantes Cedex, France
| | - L L Grégoire
- Unité de Recherche Clinique, Université de Toulouse, INP, Ecole Nationale Vétérinaire de Toulouse, F-31076 cedex 03 Toulouse, France
| | - A E Périgaud
- Unité de Recherche Clinique, Université de Toulouse, INP, Ecole Nationale Vétérinaire de Toulouse, F-31076 cedex 03 Toulouse, France
| | - D Concordet
- UMR 1331 Toxalim, INRA, Université de Toulouse, INP, Ecole Nationale Vétérinaire de Toulouse, F-31076 cedex 03 Toulouse, France
| | - V Biourge
- Royal Canin SAS, Centre de Recherches, F-30470, Aimargues, France
| | - H P Lefebvre
- Unité de Recherche Clinique, Université de Toulouse, INP, Ecole Nationale Vétérinaire de Toulouse, F-31076 cedex 03 Toulouse, France
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Abstract
Practical relevance: Routinely used markers of renal function in clinical practice include urea and creatinine. However, these are insensitive markers, particularly in the early stages of kidney disease. Measurement of glomerular filtration rate (GFR) is regarded as the most sensitive index of functioning renal mass. It may be useful for feline patients in varying clinical scenarios; for example, where a more accurate measurement of renal function may aid diagnosis, to enable response to therapeutic interventions to be more closely monitored, or to evaluate renal function prior to the use of nephrotoxic or renally cleared drugs. Clinical challenges: Traditional methods of measuring GFR, such as renal clearance or multisample plasma clearance techniques, are generally impractical for clinical use. Limited sampling and single sample plasma clearance methods using the filtration marker iohexol have been validated in cats. These have the advantages of reduced stress to cats associated with repeated sampling and reduced costs of analysis, and therefore offer greater clinical utility. Attempts to develop an estimated GFR (eGFR) formula similar to that used in human patients have been made in cats, although currently an accurate and reliable formula is not available. Audience: This review presents the basis for the theoretical understanding and practical measurement of GFR for any veterinary practitioner wishing to obtain a more accurate and sensitive assessment of renal function than routinely used markers provide. Evidence base: The review draws evidence from peer-reviewed publications, the author’s PhD thesis and also clinical experience.
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Affiliation(s)
- Natalie Finch
- School of Veterinary Sciences, University of Bristol, Langford, Bristol BS40 7UD, UK
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Valentina M, Grazia G, Pierre M, Gloria B, Ilaria L. A Limited Sampling, Simple, and Useful Method for Determination of Glomerular Filtration Rate in Cats by Using a New Accurate HPLC Method to Measure Iohexol Plasmatic Concentrations. J Vet Med 2013; 2013:569121. [PMID: 26464907 DOI: 10.1155/2013/569121] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2013] [Revised: 09/05/2013] [Accepted: 09/17/2013] [Indexed: 11/17/2022] Open
Abstract
Glomerular filtration rate (GFR) is still a highly underutilized tool in cats because available methods are not easy to be performed in clinical practice. Iohexol (IOX) has been shown to be a useful and reliable marker of GFR both in animals and in humans. The aim of the present study was to develop a rapid and reliable method for measuring IOX in feline plasma and to evaluate the accuracy of limited sampling models to establish a low-cost and clinically suitable GFR test. IOX concentrations were determined by using a new HPLC-UV method. GFR was assessed as plasma clearance of IOX, which was calculated by dividing dose administered by area under the curve of plasmatic concentration versus time (AUC), and indexed to body weight (BW). Correlation and agreement analysis between the GFR values obtained by a seven-point clearance method and the GFR values determined by the application of simplified sample combinations indicated that the 3-blood sample clearance model (5, 30, and 60 min) was the best simplified method because it provided an accurate GFR value in only one hour. The reported method is a simple and accurate way of GFR determination, which may be easily used in a clinical setting.
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Restitutti F, Laitinen MR, Raekallio MR, Vainionpää M, O’Brien RT, Kuusela E, Vainio OM. Effect of MK‐467 on organ blood flow parameters detected by contrast‐enhanced ultrasound in dogs treated with dexmedetomidine. Vet Anaesth Analg 2013; 40:e48-56. [DOI: 10.1111/vaa.12058] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2012] [Accepted: 01/21/2013] [Indexed: 11/30/2022]
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Abstract
Serum creatinine concentration is insensitive for detecting kidney injury and does not assist in differentiation between glomerular versus tubular damage. Advanced renal function tests, including glomerular filtration rate testing, determining fractional excretion of electrolytes, and assay of urine biomarkers, may allow earlier detection of reduced renal function mass, differentiation of renal from non-renal causes of azotemia, and assist with localization of damage. This article reviews the principles, indications, and limitations of these tests and describes their use in sample clinical scenarios.
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Affiliation(s)
- Barrak M Pressler
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, The Ohio State University, 601 Vernon Tharp Street, Columbus, OH 43210, USA.
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Kennedy A, Innis C, Rumbeiha W. Determination of Glomerular Filtration Rate in Juvenile Kemp's Ridley Turtles (Lepidochelys kempii) Using Iohexol Clearance, with Preliminary Comparison of Clinically Healthy Turtles vs. Those with Renal Disease. ACTA ACUST UNITED AC 2013. [DOI: 10.5818/1529-9651-22.1-2.25] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
| | | | - Wilson Rumbeiha
- 2. Diagnostic Center for Population and Animal Health, Michigan State University, East Lansing, MI 48824, USA
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Finch N, Heiene R, Elliott J, Syme H, Peters A. A Single Sample Method for Estimating Glomerular Filtration Rate in Cats. J Vet Intern Med 2013; 27:782-90. [DOI: 10.1111/jvim.12089] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2011] [Revised: 02/14/2013] [Accepted: 03/11/2013] [Indexed: 11/29/2022] Open
Affiliation(s)
| | - R. Heiene
- Norwegian School of Veterinary Science; Oslo Norway
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Nishida M, Uechi M, Kono S, Harada K, Fujiwara M. Estimating glomerular filtration rate in healthy dogs using inulin without urine collection. Res Vet Sci 2012; 93:398-403. [DOI: 10.1016/j.rvsc.2011.08.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2011] [Revised: 07/02/2011] [Accepted: 08/04/2011] [Indexed: 11/17/2022]
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Finch NC, Syme HM, Elliott J, Peters AM, Gerritsen R, Croubels S, Heiene R. Glomerular filtration rate estimation by use of a correction formula for slope-intercept plasma iohexol clearance in cats. Am J Vet Res 2011; 72:1652-9. [DOI: 10.2460/ajvr.72.12.1652] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Von Hendy-Willson VE, Pressler BM. An overview of glomerular filtration rate testing in dogs and cats. Vet J 2011; 188:156-65. [PMID: 20541957 PMCID: PMC2980797 DOI: 10.1016/j.tvjl.2010.05.006] [Citation(s) in RCA: 79] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2009] [Revised: 04/21/2010] [Accepted: 05/07/2010] [Indexed: 12/25/2022]
Abstract
Determination of glomerular filtration rate (GFR) is a valuable, yet underused, diagnostic tool for evaluating renal function in dogs and cats. This article first reviews the hormonal and hemodynamic factors which contribute to GFR, followed by a description of considerations when selecting a pharmacokinetic model and methods of animal-to-animal standardization. The best-characterized existing GFR markers, including creatinine, radiolabeled markers, and iohexol, are reviewed in depth, as well as alternative but lesser used techniques. A weighted means analysis of reported GFR measurements in healthy dogs and cats and a review of selected studies that have examined GFR alterations in animals with naturally occurring and experimental diseases provide the reader with preliminary guidelines on expected GFR results in these species and disease conditions.
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Affiliation(s)
| | - Barrak M. Pressler
- Department of Veterinary Clinical Sciences, Purdue University, West Lafayette, IN 47907 USA
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Saam DE, Liptak JM, Stalker MJ, Chun R. Predictors of outcome in dogs treated with adjuvant carboplatin for appendicular osteosarcoma: 65 cases (1996-2006). J Am Vet Med Assoc 2011; 238:195-206. [PMID: 21235373 DOI: 10.2460/javma.238.2.195] [Citation(s) in RCA: 50] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To determine outcomes and prognostic factors for those outcomes in dogs with appendicular osteosarcoma treated with curative-intent surgery and adjuvant carboplatin. DESIGN Retrospective case series. ANIMALS 65 client-owned dogs with appendicular osteosarcoma and no evidence of gross metastatic disease at the time of diagnosis. PROCEDURES Medical records of dogs that underwent limb amputation or distal ulnectomy and adjuvant carboplatin treatment for appendicular osteosarcoma were reviewed. Adverse effects of chemotherapy and findings regarding preoperative biopsy specimens and postoperative diagnostic imaging were recorded. Signalment, clinical history, and chemotherapy variables were evaluated for associations with outcome. Histologic grade and other variables were evaluated for association with outcome for 38 tumors that were retrospectively graded. RESULTS The median disease-free interval was 137 days (95% confidence interval [CI], 112 to 177 days). Median survival time was 277 days (95% CI, 203 to 355 days). The 1-, 2-, and 3-year survival rates were 36%, 22%, and 19%, respectively. None of the chemotherapy variables were associated with outcome. Preoperative proteinuria was the only clinical variable associated with poor outcome. Histologic features of tumors associated with a poor outcome were intravascular invasion, mitotic index > 5 in 3 microscopic hpfs, and grade III classification. CONCLUSIONS AND CLINICAL RELEVANCE Carboplatin administration was well tolerated and resulted in a disease-free interval and median survival time similar to those of other published protocols.
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Affiliation(s)
- Dianna E Saam
- MedVet Medical and Cancer Center for Pets, 300 E Wilson Bridge Rd, Worthington, OH 43085, USA.
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Heiene R, Eliassen KA, Risøen U, Neal LA, Cowgill LD. Glomerular filtration rate in dogs as estimated via plasma clearance of inulin and iohexol and use of limited-sample methods. Am J Vet Res 2010; 71:1100-7. [DOI: 10.2460/ajvr.71.9.1100] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Vandermeulen E, De Sadeleer C, Piepsz A, Ham HR, Dobbeleir AA, Vermeire ST, Van Hoek IM, Daminet S, Slegers G, Peremans KY. Determination of optimal sampling times for a two blood sample clearance method using 51 Cr-EDTA in cats. J Feline Med Surg 2010; 12:577-83. [DOI: 10.1016/j.jfms.2010.01.011] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/21/2010] [Indexed: 11/22/2022]
Abstract
Estimation of the glomerular filtration rate (GFR) is a useful tool in the evaluation of kidney function in feline medicine. GFR can be determined by measuring the rate of tracer disappearance from the blood, and although these measurements are generally performed by multi-sampling techniques, simplified methods are more convenient in clinical practice. The optimal times for a simplified sampling strategy with two blood samples (2BS) for GFR measurement in cats using plasma 51chromium ethylene diamine tetra-acetic acid (51Cr-EDTA) clearance were investigated. After intravenous administration of 51Cr-EDTA, seven blood samples were obtained in 46 cats (19 euthyroid and 27 hyperthyroid cats, none with previously diagnosed chronic kidney disease (CKD)). The plasma clearance was then calculated from the seven point blood kinetics (7BS) and used for comparison to define the optimal sampling strategy by correlating different pairs of time points to the reference method. Mean GFR estimation for the reference method was 3.7±2.5 ml/min/kg (mean±standard deviation (SD)). Several pairs of sampling times were highly correlated with this reference method ( r2≥0.980), with the best results when the first sample was taken 30 min after tracer injection and the second sample between 198 and 222 min after injection; or with the first sample at 36 min and the second at 234 or 240 min ( r2 for both combinations=0.984). Because of the similarity of GFR values obtained with the 2BS method in comparison to the values obtained with the 7BS reference method, the simplified method may offer an alternative for GFR estimation. Although a wide range of GFR values was found in the included group of cats, the applicability should be confirmed in cats suspected of renal disease and with confirmed CKD. Furthermore, although no indications of age-related effect were found in this study, a possible influence of age should be included in future studies.
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Abstract
OBJECTIVE To determine whether a glomerular filtration rate (GFR) assay based on serum iohexol clearance can be used to predict carboplatin clearance in cats. ANIMALS 10 cats with tumors. PROCEDURES GFR was measured concurrently by use of plasma clearance of technetium Tc 99m-labeled diethylenetriaminepentaacetic acid ((99m)Tc-DTPA) to yield GFR(99mTc-DTPA) and serum clearance of iohexol to yield GFR(Iohexol). A single dose of carboplatin was administered IV as a bolus. Dose was calculated by use of a target value for the area under the plasma platinum concentration-versus-time curve (AUC(Target)) and estimation of platinum clearance (CL(PT)) derived from GFR(99mTc-DTPA) as follows: dose = AUC(Target) x 2.6 x GFR(99mTc-DTPA) x body weight, where AUC(Target) is 2.75 min.mg.mL(-1). Plasma platinum concentrations were measured via atomic absorption spectrophotometry. Values for GFR(99mTc-DTPA) and GFR(Iohexol) were compared by use of least-squares regression and Bland-Altman analysis. Least-squares regression was used to determine whether CL(PT) could be predicted from GFR(99mTc-DTPA) or GFR(Iohexol) (or both). RESULTS GFR(99mTc-DTPA) and GFR(Iohexol) were strongly correlated (r = 0.90), but GFR(Iohexol) values were significantly larger by a factor of approximately 1.4. Platinum clearance had a significant linear relationship to GFR(99mTc-DTPA) (CL(PT) = 2.5 x GFR(99mTc-DTPA)) and to GFR(Iohexol) (CL(PT) = [1.3 x GFR(Iohexol)] + 1.4). CONCLUSIONS AND CLINICAL RELEVANCE In cats, serum iohexol clearance was an accurate predictor of CL(PT) and can be used to calculate the carboplatin dose as follows: dose = AUC(Target) x ([1.3 x GFR(Iohexol)] + 1.4) x body weight.
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Affiliation(s)
- Dennis B Bailey
- Department of Clinical Sciences, College of Veterinary Medicine, Cornell University, Ithaca, NY 14853, USA
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Pöytäkangas M, Saario-Paunio E, Putkonen T, Saastamoinen I, Frias R, Spillmann T, Saloniemi H. Rapid LC-UV Analysis of Iohexol in Canine Plasma for Glomerular Filtration Rate Determination. Chromatographia 2010. [DOI: 10.1365/s10337-009-1445-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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Goodman LA, Brown SA, Torres BT, Reynolds LR, Budsberg SC. Effects of meloxicam on plasma iohexol clearance as a marker of glomerular filtration rate in conscious healthy cats. Am J Vet Res 2009; 70:826-30. [DOI: 10.2460/ajvr.70.7.826] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Bailey DB, Rassnick KM, Dykes NL, Pendyala L. Phase I evaluation of carboplatin by use of a dosing strategy based on a targeted area under the platinum concentration-versus-time curve and individual glomerular filtration rate in cats with tumors. Am J Vet Res 2009; 70:770-6. [DOI: 10.2460/ajvr.70.6.770] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Heiene R, Reynolds BS, Bexfield NH, Larsen S, Gerritsen RJ. Estimation of glomerular filtration rate via 2- and 4-sample plasma clearance of iohexol and creatinine in clinically normal cats. Am J Vet Res 2009; 70:176-85. [DOI: 10.2460/ajvr.70.2.176] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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van Hoek I, Lefebvre H, Kooistra H, Croubels S, Binst D, Peremans K, Daminet S. Plasma Clearance of Exogenous Creatinine, Exo-Iohexol, and Endo-Iohexol in Hyperthyroid Cats before and after Treatment with Radioiodine. J Vet Intern Med 2008; 22:879-85. [DOI: 10.1111/j.1939-1676.2008.0110.x] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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Hoek I, Vandermeulen E, Duchateau L, Lefebvre H, Croubels S, Peremans K, Polis I, Daminet S. Comparison and Reproducibility of Plasma Clearance of Exogenous Creatinine, Exo-iohexol, Endo-iohexol, and 51 Cr-EDTA in Young Adult and Aged Healthy Cats. J Vet Intern Med 2007; 21:950-8. [DOI: 10.1111/j.1939-1676.2007.tb03048.x] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
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