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Pereira AF, Jota Baptista C, Faustino-Rocha A, Oliveira PA, Coelho AC. Renal Biomarkers in Companion Animals-A Review. Animals (Basel) 2025; 15:818. [PMID: 40150347 PMCID: PMC11939308 DOI: 10.3390/ani15060818] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2025] [Revised: 02/27/2025] [Accepted: 03/10/2025] [Indexed: 03/29/2025] Open
Abstract
Recent advancements in molecular biology have led to the discovery of potential biomarkers for the diagnosis of acute kidney disease (AKD) and chronic kidney disease (CKD). The use of multiple biomarkers in the diagnosis of kidney disease has the potential to enhance both specificity and sensitivity, enabling early detection and intervention that could ultimately reduce morbidity and mortality rates. This review provides an overview of studies on urine and blood biomarkers and examines their utility and significance in various clinical settings. Further and continuous research is needed to support the application of these biomarkers in clinical practice to facilitate early diagnosis, guidance for different interventions, and the monitoring of disease progression.
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Affiliation(s)
- Ana Filipa Pereira
- Centre for the Research and Technology of Agroenvironmental and Biological Sciences (CITAB), Inov4Agro, University of Trás-os-Montes e Alto Douro (UTAD), Quinta de Prados, 5001-801 Vila Real, Portugal; (A.F.-R.); (P.A.O.); (A.C.C.)
- Animal and Veterinary Research Centre (CECAV), Associated Laboratory for Animal and Veterinary Sciences (AL4AnimalS), University of Trás-os-Montes e Alto Douro (UTAD), 5001-801 Vila Real, Portugal
| | - Catarina Jota Baptista
- Centre for the Research and Technology of Agroenvironmental and Biological Sciences (CITAB), Inov4Agro, University of Trás-os-Montes e Alto Douro (UTAD), Quinta de Prados, 5001-801 Vila Real, Portugal; (A.F.-R.); (P.A.O.); (A.C.C.)
- Egas Moniz Center for Interdisciplinary Research (CiiEM), Egas Moniz School of Health & Science, 2829-511 Almada, Portugal
| | - Ana Faustino-Rocha
- Centre for the Research and Technology of Agroenvironmental and Biological Sciences (CITAB), Inov4Agro, University of Trás-os-Montes e Alto Douro (UTAD), Quinta de Prados, 5001-801 Vila Real, Portugal; (A.F.-R.); (P.A.O.); (A.C.C.)
- Department of Zootechnics, School of Sciences and Technology (ECT), University of Évora, 7004-516 Évora, Portugal
- Comprehensive Health Research Centre (CHRC), 7004-516 Évora, Portugal
| | - Paula A. Oliveira
- Centre for the Research and Technology of Agroenvironmental and Biological Sciences (CITAB), Inov4Agro, University of Trás-os-Montes e Alto Douro (UTAD), Quinta de Prados, 5001-801 Vila Real, Portugal; (A.F.-R.); (P.A.O.); (A.C.C.)
- Department of Veterinary Sciences, UTAD, 5001-801 Vila Real, Portugal
| | - Ana Cláudia Coelho
- Centre for the Research and Technology of Agroenvironmental and Biological Sciences (CITAB), Inov4Agro, University of Trás-os-Montes e Alto Douro (UTAD), Quinta de Prados, 5001-801 Vila Real, Portugal; (A.F.-R.); (P.A.O.); (A.C.C.)
- Department of Veterinary Sciences, UTAD, 5001-801 Vila Real, Portugal
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Paukner K, Filipejova Z, Mareš J, Vávra M, Rehakova K, Proks P, Gabriel V, Crha M. A comprehensive analysis of albuminuria in canine chronic kidney disease. Vet Med Sci 2024; 10:e1403. [PMID: 38419297 PMCID: PMC10902581 DOI: 10.1002/vms3.1403] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Revised: 01/29/2024] [Accepted: 02/09/2024] [Indexed: 03/02/2024] Open
Abstract
BACKGROUND Albuminuria, an important marker of decreased kidney function in chronic kidney disease (CKD), is not routinely used for CKD detection or proteinuria appearance. Its relationships with biochemical parameters and blood pressure in dogs are poorly understood. OBJECTIVES This study aimed to evaluate the relationship of albuminuria with various CKD markers, its correlation with the urinary protein to creatinine ratio (UPC), and hypertension in dogs with early stages of CKD. It also sought to determine the usability of the urinary albumin to creatinine ratio (UAC) for CKD screening. METHODS The study reviewed records of 102 dogs, categorising them into four groups based on disease status. UAC and UPC ratio, biochemistry and haematology variables, age, and systolic blood pressure were determined. RESULTS The Pearson's correlation coefficient between log-transformed values of UPC and UAC was r = 0.902 (95% CI: 0.87 to 0.93). Median UAC ratio values were 2.1 mg/g for the Healthy control group (n = 17), 54.2 mg/g for early stages CKD (n = 42), 5.8 mg/g for Acute sick control (n = 30), and 104 mg/g for Chronic sick control (n = 13). Thresholding UAC ratio as an indicator for impaired kidney function with the threshold of 10 mg/g (established based on the receiver operating characteristic curve) had a sensitivity 81.8%, specificity of 89.4%, positive predictive value (PPV) 90%, and negative predictive value (NPV) 80.1%. The correlation of UAC with biochemistry and haematology variables was statistically significant; for SDMA (μg/L), it was r = 0.566 and for other variables, it was weak to moderate. UAC was markedly elevated in cases of severe hypertension. CONCLUSIONS UAC ratio was significantly different among dogs with impaired and not impaired kidney function. The correlation strength for the UAC and UPC ratios was high. UAC ratio may be a promising marker for proteinuria analysis in dogs with CKD or other kidney function alterations.
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Affiliation(s)
- Karel Paukner
- Small Animal ClinicUniversity of Veterinary Sciences BrnoBrnoCzech Republic
- Center for Experimental MedicineInstitute for Clinical and Experimental MedicinePragueCzech Republic
| | - Zita Filipejova
- Small Animal ClinicUniversity of Veterinary Sciences BrnoBrnoCzech Republic
| | - Jan Mareš
- Department of Data ScienceInstitute for Clinical and Experimental MedicinePragueCzech Republic
| | - Miloš Vávra
- Small Animal ClinicUniversity of Veterinary Sciences BrnoBrnoCzech Republic
| | - Kristina Rehakova
- Small Animal Clinical LaboratoryUniversity of Veterinary Sciences BrnoBrnoCzech Republic
| | - Pavel Proks
- Small Animal ClinicUniversity of Veterinary Sciences BrnoBrnoCzech Republic
| | - Vojtech Gabriel
- Department of Biomedical SciencesCollege of Veterinary Medicine, Iowa State UniversityAmesIowaUSA
| | - Michal Crha
- Small Animal ClinicUniversity of Veterinary Sciences BrnoBrnoCzech Republic
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Barchilon M, Perez‐Nieves N, Palerme J. Evaluation of a urine dipstick protein to urine specific gravity ratio for the detection of proteinuria in dogs and cats. J Vet Intern Med 2024; 38:1060-1067. [PMID: 38305084 PMCID: PMC10937511 DOI: 10.1111/jvim.17001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2023] [Accepted: 01/22/2024] [Indexed: 02/03/2024] Open
Abstract
BACKGROUND The utility of urine dipsticks for the quantification of proteinuria is limited because of the influence of urine specific gravity (USG). To circumvent the need for urine protein creatinine ratios (UPCR) some have proposed a calculated dipstick urine protein to USG ratio (DUR) for the detection of proteinuria. However, the performance of DUR has not been evaluated in veterinary patients. OBJECTIVES Evaluate the correlation between DUR and UPCR, while also assessing the effect of urine characteristics on this relationship and evaluating the performance of DUR in detecting proteinuria. ANIMALS Urine samples from 308 dogs and 70 cats. METHODS Retrospective cohort study of urinalyses and UPCRs from dogs and cats collected between 2016 and 2021. RESULTS Both canine and feline urine samples showed a positive moderate correlation between the UPCR and DUR. The correlation was not influenced by the presence of active urine sediment, glucosuria, or urine pH. In detecting canine urine samples with a UPCR >0.5, an optimal DUR of 1.4 had sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of 89%, 83%, 96%, and 63%, respectively. In detecting feline urine samples with a UPCR >0.4, an optimal DUR of 2.1 had sensitivity, specificity, PPV, and NPV of 70%, 100%, 100%, and 75%, respectively. CONCLUSIONS AND CLINICAL IMPORTANCE Use of the DUR can be a relatively reliable method for identification of proteinuria. However, given its poor NPV, the DUR cannot be recommended for exclusion of proteinuric patients.
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Affiliation(s)
- Michael Barchilon
- Department of Veterinary Medicine and SurgeryCollege of Veterinary Medicine, University of MissouriColumbiaMissouriUSA
| | - Nichole Perez‐Nieves
- Department of Veterinary Medicine and SurgeryCollege of Veterinary Medicine, University of MissouriColumbiaMissouriUSA
| | - Jean‐Sébastien Palerme
- Department of Veterinary Clinical SciencesCollege of Veterinary Medicine, Iowa State UniversityAmesIowaUSA
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4
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Degenhardt L, Dorsch R, Hartmann K, Dörfelt R. Serum amyloid A in cats with renal azotemia. Vet World 2023; 16:1673-1681. [PMID: 37766698 PMCID: PMC10521177 DOI: 10.14202/vetworld.2023.1673-1681] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2023] [Accepted: 07/18/2023] [Indexed: 09/29/2023] Open
Abstract
Background and Aim The concentration of the feline acute-phase protein serum amyloid A (SAA) increases in cats with acute inflammatory diseases. However, it is unclear whether SAA concentration increases in cats with azotemic kidney disease or whether it can aid in differentiating acute kidney injury (AKI) from chronic kidney disease (CKD). Similarly, whether SAA concentration can be used as a prognostic marker is also unclear. Therefore, this study aimed to evaluate the SAA concentrations in cats with azotemic kidney disease and determine whether SAA concentrations can be used to differentiate between AKI, CKD, and "acute on CKD" (AoC). In addition, we evaluated whether SAA concentration could serve as a prognostic parameter. Moreover, we determined the correlations between SAA concentration and temperature; creatinine, urea, and albumin concentrations; leukocyte count; and urine protein/creatinine (UP/C). Materials and Methods Forty-eight client-owned azotemic cats (creatinine >250 μmol/L) were included in this prospective study. Cats with pre- and post-renal azotemia were excluded from the study. The causes of azotemia were differentiated into AKI, CKD, and AoC. The SAA concentrations were analyzed through turbidimetric immunoassay at the time of admission. Data were analyzed using the Mann-Whitney U, Kruskal-Wallis, Chi-Square, Fisher's exact, and Spearman correlation tests. p ≤ 0.05 was considered statistically significant. Results Serum amyloid A concentration increased in 5/12 cats with AKI, 7/22 cats with CKD, and 9/14 cats with AoC (p = 0.234). The median SAA concentration in cats with AKI, CKD, and AoC whose SAA concentration was ≥5 mg/L was 174 mg/L (10-281 mg/L), 125 mg/L (6-269 mg/L), and 143 mg/L (7-316 mg/L), respectively (p = 0.697), with no significant differences observed between the groups. The median SAA concentration did not differ significantly between survivors (125 mg/L, 10-316 mg/L) and non-survivors (149 mg/L, 6-281 mg/L; p = 0.915) with SAA concentration ≥5 mg/L. Conclusion Serum amyloid A concentration increased in 44% of the cats with azotemia. However, it cannot be used to differentiate AKI from CKD or as a prognostic marker. Serum amyloid A concentration was correlated with neutrophil count, albumin concentration, and UP/C, and the presence of comorbidities may influence SAA concentration.
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Affiliation(s)
- Laura Degenhardt
- LMU Small Animal Clinic, Center for Clinical Veterinary Medicine, LMU München, Veterinärstraße 13, 80539, Munich, Germany
| | - Roswitha Dorsch
- LMU Small Animal Clinic, Center for Clinical Veterinary Medicine, LMU München, Veterinärstraße 13, 80539, Munich, Germany
| | - Katrin Hartmann
- LMU Small Animal Clinic, Center for Clinical Veterinary Medicine, LMU München, Veterinärstraße 13, 80539, Munich, Germany
| | - René Dörfelt
- LMU Small Animal Clinic, Center for Clinical Veterinary Medicine, LMU München, Veterinärstraße 13, 80539, Munich, Germany
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Urinary Protein/Creatinine Ratio in Feline Medicine: Reasons to Perform It and Its Role in Clinical Practice-A Retrospective Study. Animals (Basel) 2022; 12:ani12121575. [PMID: 35739913 PMCID: PMC9219505 DOI: 10.3390/ani12121575] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Revised: 06/09/2022] [Accepted: 06/17/2022] [Indexed: 11/16/2022] Open
Abstract
This study aimed at understanding the reasons veterinarians conduct a urinary protein/creatinine ratio (UPCR) in cats, correlating it with signalment, dipstick proteinuria tests, and urine specific gravity (USG) and assessing its role in chronic kidney disease (CKD) diagnosis and monitoring. A retrospective study was conducted, including medical data from cats consulted between 2016 and 2018 in a veterinary teaching hospital and submitted to at least one UPCR measurement. A total of 140 cats were included: 35% non-proteinuric (UPCR < 0.2), 25% borderline proteinuric (0.2 < UPCR < 0.4), and 40% overtly proteinuric (UPCR > 0.4). In contrast to other studies, there was no association between UPCR and male reproductive status. UPCR was mainly requested for CKD diagnosis and monitoring. Correlation between UPCR and combined results from dipstick tests and USG was low and inconsistent. Proteinuric CKD cats had a worse outcome at both 6 (odds ratio (OR 4.04) and 12 months (OR 4.36)), and this finding was more pronounced for severely proteinuric cases in which the OR for death was 4.36 and 6.00 at 6 and at 12 months, respectively. In addition to reinforcing the negative prognostic value of proteinuria, this study stresses the low and the inconsistent agreement between UPCR and the combined results of dipstick tests and USG in cats.
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Prüllage ML, Schwendenwein I, Eberspächer-Schweda E, Kneissl S. Does intravenous contrast medium administration result in altered renal biomarkers? A study in clinically stable cats with and without azotemia. J Feline Med Surg 2022; 24:565-579. [PMID: 34493101 PMCID: PMC11104225 DOI: 10.1177/1098612x211038535] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVES The aim of this study was to determine the prevalence of post-contrast acute kidney injury or comparable side effects on kidney function in cats receiving the non-ionic, iodinated agent ioversol and/or paramagnetic agent gadoteric acid. METHODS Fifty-two animals were divided into four groups on the basis of contrast medium administration for imaging: ioversol (n = 27), gadoteric acid (n = 12), dual contrast media (n = 4) or control, which received an infusion of isotone intravenous fluids only during anaesthesia (n = 9). Blood and urine samples were obtained three times after contrast administration and compared with values obtained prior to administration of the contrast medium. Creatinine (<1.60 mg/dl), symmetric dimethylarginine (SDMA; ⩽14 μg/dl), urine protein:creatinine ratio (UPC; <0.2) and critical differences for creatinine (<0.3 mg/dl) and SDMA (<5.98 μg/dl) were measured. RESULTS No significant short-term effects on mean creatinine, SDMA and UPC measurements were seen. Borderline proteinuria (UPC, 0.2-0.4) was detected in 11.4% of cases after contrast media administration. A UPC of more than 0.2 in five cases indicated that contrast media may affect kidney function, leading to (transient) proteinuria. CONCLUSIONS AND RELEVANCE This study found no side effect on renal function following the administration of ioversol or gadoteric acid, provided patients were adequately hydrated. However, the clinical relevance of proteinuria in some cats needs to be evaluated in future studies.
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Affiliation(s)
- Maria Laura Prüllage
- Diagnostic Imaging, Department of Companion Animals and Horses, University of Veterinary Medicine, Vienna, Austria
| | - Ilse Schwendenwein
- Clinical Pathology Platform, Department of Pathobiology, University of Veterinary Medicine, Vienna, Austria
| | - Eva Eberspächer-Schweda
- Anaesthesiology and Perioperative Intensive-Care Medicine, Department of Companion Animals and Horses, University of Veterinary Medicine, Vienna, Austria
| | - Sibylle Kneissl
- Diagnostic Imaging, Department of Companion Animals and Horses, University of Veterinary Medicine, Vienna, Austria
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7
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Athanasiou LV, Katsoulos PD, Katsogiannou EG, Pazarakioti AT, Spanou VM, Tsokana CN, Apostolidis KN, Tzivara AH, Polizopoulou ZS. Evaluation of Heller's reaction and the urine dipstick method alone or in combination to detect proteinuria in sheep. Vet Clin Pathol 2022; 51:543-550. [PMID: 35624545 DOI: 10.1111/vcp.13131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Revised: 11/21/2021] [Accepted: 02/15/2022] [Indexed: 11/29/2022]
Abstract
BACKGROUND Urine dipstick and Heller's reaction are easy first-line screening tests for the detection of proteinuria; however, the performance of these methods in alkaline ovine urine is largely unknown. OBJECTIVE The aim of this study was to evaluate the diagnostic performance of Heller's reaction alone or in combination with dipstick for the detection of proteinuria in sheep, using the urine protein to creatinine ratio (UP/C) with two cut-off values as the reference method. METHODS Ninety-eight urine samples were collected from sheep using the transient apnea method. Heller's reaction, the dipstick method, and the UP/C ratio were used to assess proteinuria. The results were statistically analyzed twice, based on two different UP/C cut-off values of 0.2 and 0.5. Cohen's kappa value was used to determine the agreement between the UP/C ratios and Heller's reaction, the dipstick method, or the combination of methods. Sensitivity, specificity, and positive and negative likelihood ratios were calculated. ROC curves were also generated, and the areas under the curve (AUC) were evaluated to determine the optimal threshold for the numerical values of the two methods. RESULTS Heller's reaction is more specific (96.67% and 96.00% when the cut-off value is 0.2 and 0.5, respectively) than the dipstick method, while the dipstick method was more sensitive (91.18% and 91.30%, when the cut-off value was 0.2 and 0.5, respectively) than Heller's reaction for the detection of proteinuria. Both tests were accurate when any grade >0 was considered positive. CONCLUSIONS Proteinuria can almost be excluded in ovine urine samples with negative Heller's reaction and dipstick test.
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Affiliation(s)
- Labrini V Athanasiou
- Clinic of Medicine, Faculty of Veterinary Medicine, University of Thessaly, Karditsa, Greece
| | - Panagiotis D Katsoulos
- Clinic of Farm Animals, School of Veterinary Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Eleni G Katsogiannou
- Clinic of Medicine, Faculty of Veterinary Medicine, University of Thessaly, Karditsa, Greece
| | | | - Victoria M Spanou
- Clinic of Medicine, Faculty of Veterinary Medicine, University of Thessaly, Karditsa, Greece
| | - Constantina N Tsokana
- Clinic of Medicine, Faculty of Veterinary Medicine, University of Thessaly, Karditsa, Greece
| | - Kosmas N Apostolidis
- Clinic of Medicine, Faculty of Veterinary Medicine, University of Thessaly, Karditsa, Greece
| | - Athanasia H Tzivara
- Clinic of Medicine, Faculty of Veterinary Medicine, University of Thessaly, Karditsa, Greece
| | - Zoe S Polizopoulou
- Diagnostic Laboratory, School of Veterinary Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
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8
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Kongtasai T, Paepe D, Meyer E, Mortier F, Marynissen S, Stammeleer L, Defauw P, Daminet S. Renal biomarkers in cats: A review of the current status in chronic kidney disease. J Vet Intern Med 2022; 36:379-396. [PMID: 35218249 PMCID: PMC8965260 DOI: 10.1111/jvim.16377] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2020] [Revised: 01/17/2022] [Accepted: 01/19/2022] [Indexed: 12/22/2022] Open
Abstract
Serum creatinine concentration, the classical biomarker of chronic kidney disease (CKD) in cats, has important limitations that decrease its value as a biomarker of early CKD. Recently, serum symmetric dimethylarginine concentration was introduced as a novel glomerular filtration rate biomarker for the early detection of CKD in cats. However, data on its specificity are still limited. The limitations of conventional biomarkers and the desire for early therapeutic intervention in cats with CKD to improve outcomes have prompted the discovery and validation of novel renal biomarkers to detect glomerular or tubular dysfunction. Changes in the serum or urinary concentrations of these biomarkers may indicate early kidney damage or predict the progression of kidney before changes in conventional biomarkers are detectable. This review summarizes current knowledge on renal biomarkers in CKD in cats, a field that has progressed substantially over the last 5 years.
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Affiliation(s)
- Thirawut Kongtasai
- Small Animal Department, Faculty of Veterinary Science, Ghent University, Merelbeke, Belgium.,Department of Clinical Sciences and Public Health, Faculty of Veterinary Science, Mahidol University, Nakhon Pathom, Thailand
| | - Dominique Paepe
- Small Animal Department, Faculty of Veterinary Science, Ghent University, Merelbeke, Belgium
| | - Evelyne Meyer
- Department of Pharmacology, Toxicology and Biochemistry, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium
| | - Femke Mortier
- Small Animal Department, Faculty of Veterinary Science, Ghent University, Merelbeke, Belgium
| | - Sofie Marynissen
- Small Animal Department, Faculty of Veterinary Science, Ghent University, Merelbeke, Belgium
| | - Lisa Stammeleer
- Small Animal Department, Faculty of Veterinary Science, Ghent University, Merelbeke, Belgium
| | - Pieter Defauw
- Lumbry Park Veterinary Specialists, Alton, United Kingdom
| | - Sylvie Daminet
- Small Animal Department, Faculty of Veterinary Science, Ghent University, Merelbeke, Belgium
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Harjen HJ, Anfinsen KP, Hultman J, Moldal ER, Szlosek D, Murphy R, Friis H, Peterson S, Rørtveit R. Evaluation of Urinary Clusterin and Cystatin B as Biomarkers for Renal Injury in Dogs Envenomated by the European Adder (Vipera berus). Top Companion Anim Med 2021; 46:100586. [PMID: 34583053 DOI: 10.1016/j.tcam.2021.100586] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2021] [Revised: 09/04/2021] [Accepted: 09/23/2021] [Indexed: 01/12/2023]
Abstract
Dogs are commonly bitten by the European adder (Vipera berus) but studies investigating the effects of envenomation are limited. Snakebite-related kidney injury is reported in dogs but diagnosis of acute kidney injury (AKI) might be limited by the insensitivity of routinely used renal function biomarkers. The aim of this study was to evaluate novel biomarkers of renal injury (urinary cystatin B and urinary clusterin) and biomarkers of renal function (serum creatinine and serum symmetric dimethylarginine), and urine protein to creatinine ratio in dogs envenomated by V. berus. Biomarkers were measured at presentation (T1), 12 hours (T2), 24 hours (T3), 36 hours (T4), and 14 days (T5) after snakebite and compared to a group of healthy control dogs. A secondary aim was to investigate the association between biomarker concentrations and severity of clinical signs of envenomation using a snakebite severity score (SSS). Urinary cystatin B concentrations were significantly higher at all timepoints in envenomated dogs compared to controls (P < .010), except for T5 (P = .222). Absolute urinary clusterin concentrations were not significantly different to controls at any timepoint. Compared to controls, serum creatinine and serum symmetric dimethylarginine concentrations were significantly lower in envenomated dogs at T1-T4 (P < .036) and T2-T4 (P < .036), respectively. Urine protein to creatinine ratio was higher in envenomated dogs compared to controls at T2 and T3. Urinary cystatin B concentrations at T1 were correlated with SSS (Spearman's ρ = 0.690, P < .001). The increased urinary cystatin B concentrations observed in dogs envenomated by V. berus in comparison to controls may indicate renal tubular injury in these patients.
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Affiliation(s)
- Hannah J Harjen
- Faculty of Veterinary Medicine, Department of Companion Animal Clinical Sciences, Norwegian University of Life Sciences, Oslo Norway.
| | - Kristin P Anfinsen
- Faculty of Veterinary Medicine, Department of Companion Animal Clinical Sciences, Norwegian University of Life Sciences, Oslo Norway
| | - Josefin Hultman
- Faculty of Veterinary Medicine, Department of Companion Animal Clinical Sciences, Norwegian University of Life Sciences, Oslo Norway
| | - Elena R Moldal
- Faculty of Veterinary Medicine, Department of Companion Animal Clinical Sciences, Norwegian University of Life Sciences, Oslo Norway
| | | | | | - Hanne Friis
- IDEXX Laboratories, Inc., Westbrook, ME, USA
| | | | - Runa Rørtveit
- Faculty of Veterinary Medicine, Department of Preclinical sciences and Pathology, Norwegian University of Life Sciences, Oslo Norway
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10
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Pérez-Accino J, Feo Bernabe L, Manzanilla EG, Puig J. The utility of combined urine dipstick analysis and specific gravity measurement to determine feline proteinuria. J Small Anim Pract 2020; 61:541-546. [PMID: 32692434 DOI: 10.1111/jsap.13184] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2019] [Revised: 04/27/2020] [Accepted: 05/20/2020] [Indexed: 11/26/2022]
Abstract
OBJECTIVES To assess the utility of urine dipstick strips for detection of feline proteinuria when used in combination with urine-specific gravity, compared with urine protein-to-creatinine ratio as the gold standard. MATERIALS AND METHODS Retrospective analysis of clinical records of comprehensive urine examination obtained from cats presented to a referral hospital. Diagnostic agreement and test accuracy were calculated for the dipstick test alone and in combination with the urine-specific gravity, using different cut-off values for proteinuria. Receiver-operating characteristic curves were also calculated. RESULTS A total of 121 urine samples were included. The diagnostic agreement between dipstick and urine protein-creatinine ratio was poor. A dipstick result of equal or greater than "Trace" (0.1-0.3 g/L) had a sensitivity of 81% and a specificity of 31% to detect proteinuria. Grouping the samples by urine-specific gravity did not increase dipstick agreement with the urine protein-creatinine ratio and only resulted in a slight improvement in the accuracy of detecting proteinuria. CLINICAL SIGNIFICANCE The dipstick test was not accurate for detecting proteinuria when combined with urine-specific gravity in cats. Clinicians should not rely on this test and, regardless of the urine concentration, other appropriate quantitative methods such as urine protein-creatinine ratio should always be performed to detect proteinuria in cats.
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Affiliation(s)
- J Pérez-Accino
- Ars Veterinaria Hospital, Carrer dels Cavallers 37, Barcelona, 08034, Spain.,Royal (Dick) School of Veterinary Studies, Easter Bush Campus, Roslin, EH25 9RG, UK
| | - L Feo Bernabe
- Ars Veterinaria Hospital, Carrer dels Cavallers 37, Barcelona, 08034, Spain
| | - E G Manzanilla
- Moorepark Animal and Grassland Research Centre, Teagasc, Cork, P61 C996, Ireland.,School of Veterinary Medicine, University College Dublin, Belfield, Dublin 4, Ireland
| | - J Puig
- Ars Veterinaria Hospital, Carrer dels Cavallers 37, Barcelona, 08034, Spain
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11
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Arnold JE, Camus MS, Freeman KP, Giori L, Hooijberg EH, Jeffery U, Korchia J, Meindel MJ, Moore AR, Sisson SC, Vap LM, Cook JR. ASVCP Guidelines: Principles of Quality Assurance and Standards for Veterinary Clinical Pathology (version 3.0): Developed by the American Society for Veterinary Clinical Pathology's (ASVCP) Quality Assurance and Laboratory Standards (QALS) Committee. Vet Clin Pathol 2020; 48:542-618. [PMID: 31889337 DOI: 10.1111/vcp.12810] [Citation(s) in RCA: 87] [Impact Index Per Article: 17.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Affiliation(s)
| | - Melinda S Camus
- Department of Pathology, University of Georgia College of Veterinary Medicine, Athens, GA, USA
| | | | - Luca Giori
- Department of Biomedical and Diagnostic Sciences, University of Tennessee College of Veterinary Medicine, Knoxville, TN, USA
| | - Emma H Hooijberg
- Department of Companion Animal Clinical Studies, Faculty of Veterinary Science, University of Pretoria, Pretoria, South Africa
| | - Unity Jeffery
- Department of Veterinary Pathobiology, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, TX, USA
| | - Jérémie Korchia
- Texas A&M Veterinary Medical Diagnostic Laboratory, College Station, TX, USA
| | | | - A Russell Moore
- Department of Microbiology, Immunology and Pathology, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, CO, USA
| | - Sandra C Sisson
- Cornell University College of Veterinary Medicine, Ithaca, NY, USA
| | - Linda M Vap
- Department of Microbiology, Immunology and Pathology, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, CO, USA
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Mie K, Hayashi A, Nishida H, Okamoto M, Yasuda K, Nakata M, Fukatsu K, Matsunami N, Yamashita S, Ohashi F, Akiyoshi H. Evaluation of the accuracy of urine analyzers in dogs and cats. J Vet Med Sci 2019; 81:1671-1675. [PMID: 31611480 PMCID: PMC6895637 DOI: 10.1292/jvms.18-0468] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
The accuracy of urine analyzers used for dogs and cats has remained uncertain. This study examines the agreement between results of urine analysis obtained using two devices marketed for
animals and for humans and the results of quantitative biochemical analysis. The degrees of concordance for bilirubin and ketones in the same category were ~80%, but for pH these were only
~60% in dogs and cats. Degrees of concordance for protein and the UP/C ratio clearly differed between the devices for animals and humans. We found that values for bilirubin and ketones
obtained using urine analyzers may be reliable, but pH is unlikely to be accurate enough to be clinically useful for dogs and cats.
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Affiliation(s)
- Keiichiro Mie
- Laboratory of Veterinary Surgery, Division of Veterinary Science, Course of Veterinary Science, Graduate School of Life and Environmental Sciences, Osaka Prefecture University, 1-58 Rinku-oraikita, Izumisano, Osaka 598-8531, Japan
| | - Akiyoshi Hayashi
- Hayashi Animal Hospital, 1766-13 Nii, Kokubunji, Takamatsu, Kagawa 769-0101, Japan
| | - Hidetaka Nishida
- Laboratory of Veterinary Surgery, Division of Veterinary Science, Course of Veterinary Science, Graduate School of Life and Environmental Sciences, Osaka Prefecture University, 1-58 Rinku-oraikita, Izumisano, Osaka 598-8531, Japan
| | - Mari Okamoto
- Laboratory of Veterinary Surgery, Division of Veterinary Science, Course of Veterinary Science, Graduate School of Life and Environmental Sciences, Osaka Prefecture University, 1-58 Rinku-oraikita, Izumisano, Osaka 598-8531, Japan
| | - Kazuo Yasuda
- Yasuda Animal Hospital, 5-8-12 Naruo, Nishinomiya, Hyogo 663-8184, Japan
| | - Mio Nakata
- Laboratory of Veterinary Surgery, Division of Veterinary Science, Course of Veterinary Science, Graduate School of Life and Environmental Sciences, Osaka Prefecture University, 1-58 Rinku-oraikita, Izumisano, Osaka 598-8531, Japan.,Yasuda Animal Hospital, 5-8-12 Naruo, Nishinomiya, Hyogo 663-8184, Japan
| | - Kazuyuki Fukatsu
- Fukatsu Animal Hospital, 2-10-3 Yamada-Higashi, Suita, Osaka 565-0821, Japan
| | - Norie Matsunami
- Fukatsu Animal Hospital, 2-10-3 Yamada-Higashi, Suita, Osaka 565-0821, Japan
| | - Shogo Yamashita
- Arkray, Inc., Yousuien-nai, 59 Gansuin-cho, Kamigyo-ku, Kyoto 602-0008, Japan
| | - Fumihito Ohashi
- Laboratory of Veterinary Surgery, Division of Veterinary Science, Course of Veterinary Science, Graduate School of Life and Environmental Sciences, Osaka Prefecture University, 1-58 Rinku-oraikita, Izumisano, Osaka 598-8531, Japan
| | - Hideo Akiyoshi
- Laboratory of Veterinary Surgery, Division of Veterinary Science, Course of Veterinary Science, Graduate School of Life and Environmental Sciences, Osaka Prefecture University, 1-58 Rinku-oraikita, Izumisano, Osaka 598-8531, Japan
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13
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Boag AM, Breheny C, Handel I, Gow AG. Evaluation of the effect of urine dip vs urine drip on multi-test strip results. Vet Clin Pathol 2019; 48:276-281. [PMID: 31187512 DOI: 10.1111/vcp.12730] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2018] [Revised: 10/05/2018] [Accepted: 10/16/2018] [Indexed: 11/26/2022]
Abstract
Standard operating procedures, including World Health Organization guidelines for packed cell volume, are established for in-clinic laboratory tests. No independent, evidence-based guidelines exist for dipstick urinalysis; however, manufacturer's instructions state to dip the stick into urine. In veterinary medicine, small volume urine samples could preclude dipping; therefore, a single drip per pad from a pipette or syringe is often performed. This study aimed to examine the differences between these two urine application methods prior to analysis, with the hypothesis that the method type would not effect on test results of dipstick analysis. To standardize the strip analysis method, a Siemens Clinitek Status + analyzer was used with Multistix10SG dipsticks. Three investigators tested urines from 53 dogs with a range of diseases by both methods. Results were assessed for the degree of agreement between the methods and within method variability. Overall, the agreement between methods was high. Within each method, the drip method variability was higher than that of the dip method (P = 0.012). Disagreements between methods were present, with pH and blood having the lowest agreement levels. Glucose was more likely to be positive on the drip compared with the dip methodology. This study demonstrates potential clinically relevant differences between the two methods and a higher level of variability with the drip methodology. Therefore, while the drip method could be used for practical reasons (eg, low sample volumes), this study supports the manufacturer's recommended method of dipping the dip stick into urine rather than dripping urine onto each pad with a pipette or syringe.
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Affiliation(s)
- Alisdair M Boag
- Royal (Dick) School of Veterinary Studies, University of Edinburgh, Edinburgh, UK
| | - Craig Breheny
- Royal (Dick) School of Veterinary Studies, University of Edinburgh, Edinburgh, UK
| | - Ian Handel
- Royal (Dick) School of Veterinary Studies, University of Edinburgh, Edinburgh, UK
| | - Adam G Gow
- Royal (Dick) School of Veterinary Studies, University of Edinburgh, Edinburgh, UK
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14
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Meindl AG, Lourenço BN, Coleman AE, Creevy KE. Relationships among urinary protein-to-creatinine ratio, urine specific gravity, and bacteriuria in canine urine samples. J Vet Intern Med 2018; 33:192-199. [PMID: 30506746 PMCID: PMC6335512 DOI: 10.1111/jvim.15377] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2018] [Accepted: 11/06/2018] [Indexed: 12/19/2022] Open
Abstract
Background Proteinuria is a marker of chronic kidney disease in dogs and a risk factor for increased morbidity and death. Predictive models using the results of readily available screening tests could foster early recognition. Objective To determine whether urine specific gravity (USG) and semiquantitative category of dipstick protein can be used to predict urinary protein‐to‐creatinine ratio (UP : C) and to examine the effect of urine culture results on UP : C in dogs. Animals Three hundred ninety‐four dogs (482 visits) presented to a university Community Practice Clinic or Veterinary Teaching Hospital between January 2011 and November 2015. Methods Retrospective study. Medical records were searched to identify dogs for which urinalysis, UP : C measurement, and urine culture testing were performed during a single hospital visit. Urine specific gravity, UP : C, dipstick protein concentration, and findings of urine sediment analysis and urine culture were recorded. Regression or Spearman correlation analysis was used to test for relationships between UP : C and USG within dipstick categories and between UP : C and bacterial colony‐forming units per milliliter, respectively. Cohen's kappa test was used to evaluate agreement between urine culture and UP : C testing. Results There were significant (P < .05) weak negative correlations (R2 range, 0.14‐0.37) between UP : C and USG for all nonnegative urine protein dipstick categories. The presence of a positive urine culture did not agree with the presence of abnormal UP : C (κ = −0.06). Conclusions and Clinical Importance Within dipstick protein categories, UP : C cannot be accurately predicted from USG. Repeating UP : C measurement after resolution of urinary tract infection is advisable.
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Affiliation(s)
- Alison G Meindl
- Department of Small Animal Medicine and Surgery, University of Georgia College of Veterinary Medicine, Athens, Georgia
| | - Bianca N Lourenço
- Department of Small Animal Medicine and Surgery, University of Georgia College of Veterinary Medicine, Athens, Georgia
| | - Amanda E Coleman
- Department of Small Animal Medicine and Surgery, University of Georgia College of Veterinary Medicine, Athens, Georgia
| | - Kate E Creevy
- Department of Small Animal Medicine and Surgery, University of Georgia College of Veterinary Medicine, Athens, Georgia
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15
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Conroy M, Chang YM, Brodbelt D, Elliott J. Survival after diagnosis of hypertension in cats attending primary care practice in the United Kingdom. J Vet Intern Med 2018; 32:1846-1855. [PMID: 30315661 PMCID: PMC6271307 DOI: 10.1111/jvim.15307] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2017] [Revised: 04/28/2018] [Accepted: 07/24/2018] [Indexed: 12/01/2022] Open
Abstract
Background Hypertension is common in older cats. There is limited evidence for predictors of survival after diagnosis. Hypothesis/Objectives Investigate blood pressure assessment (BPA) and hypertension diagnosis in cats attending UK primary care practices (PCPs) and factors that influence survival. Animals Cats (347 889) attending 244 UK PCPs enrolled in the VetCompass program between January 1, 2012, and December 31, 2013. Cats identified as hypertensive (282) were included in descriptive and survival analyses. Methods All electronic patient records (EPRs) were searched to identify cats that potentially had received BPA. EPRs were read in detail to identify those that had BPA. The proportion that received BPA was evaluated using a stratified analysis and the incidence of hypertension estimated. A retrospective cohort study was used to investigate survival after diagnosis (Cox proportional hazard model). Results Estimated incidence risk was 19.5% (95% confidence interval [CI], 17.5‐21.6) from the estimated 1.34% (1.30%‐1.38%) of cats that received BPA. Few cats had BPA more than once after diagnosis (median, 1; interquartile range [IQR], 0‐3), with only 9.9% of diagnosed hypertensive cats having urine protein:creatinine ratio determined. Cats diagnosed as a result of monitoring of pre‐existing disease had improved survival (hazard ratio [HR], 0.58; 95% CI, 0.37‐0.89; P = .01) compared to cats diagnosed after clinical signs were recognized. Cats that had an amlodipine dose change had improved survival (HR, 0.56; 95% CI, 0.36‐0.87; P = .01) compared to those with no dose change. Conclusions and clinical importance These data suggest improved blood pressure monitoring in clinical practice may decrease the morbidity associated with hypertension.
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Affiliation(s)
- Megan Conroy
- Department of Comparative Biomedical Sciences, Royal Veterinary College, London, United Kingdom
| | - Yu-Mei Chang
- Research Support Office, Royal Veterinary College, London, United Kingdom
| | - Dave Brodbelt
- Veterinary Epidemiology, Economics and Public Health, Royal Veterinary College, Hatfield, United Kingdom
| | - Jonathan Elliott
- Department of Comparative Biomedical Sciences, Royal Veterinary College, London, United Kingdom
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16
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17
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Giraldi M, Rossi G, Bertazzolo W, Negri S, Paltrinieri S, Scarpa P. Evaluation of the analytical variability of urine protein-to-creatinine ratio in cats. Vet Clin Pathol 2018; 47:448-457. [DOI: 10.1111/vcp.12646] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2017] [Accepted: 02/21/2018] [Indexed: 11/29/2022]
Affiliation(s)
- Marco Giraldi
- Department of Veterinary Medicine; University of Milan; Milan Italy
- Veterinary Teaching Hospital; University of Milan; Lodi Italy
| | - Gabriele Rossi
- College of Veterinary Medicine School of Veterinary and Life Science; Murdoch University; Murdoch WA Australia
| | - Walter Bertazzolo
- Veterinary Animal Hospital “Città di Pavia”; Pavia Italy
- Veterinary Laboratory “La Vallonea”; Alessano (LE) Italy
| | - Stefano Negri
- Department of Veterinary Medicine; University of Milan; Milan Italy
- Veterinary Teaching Hospital; University of Milan; Lodi Italy
| | - Saverio Paltrinieri
- Department of Veterinary Medicine; University of Milan; Milan Italy
- Veterinary Teaching Hospital; University of Milan; Lodi Italy
| | - Paola Scarpa
- Department of Veterinary Medicine; University of Milan; Milan Italy
- Veterinary Teaching Hospital; University of Milan; Lodi Italy
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18
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Giraldi M, Paltrinieri S, Zatelli A. Evaluation of the analytical variability of dipstick protein pads in canine urine. Vet Clin Pathol 2018; 47:246-251. [PMID: 29578638 DOI: 10.1111/vcp.12594] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
BACKGROUND The dipstick is a first-line and inexpensive test that can exclude the presence of proteinuria in dogs. However, no information is available about the analytical variability of canine urine dipstick analysis. OBJECTIVES The aim of this study was to assess the analytical variability in 2 dipsticks and the inter-operator variability in dipstick interpretation. METHODS Canine urine supernatants (n = 174) were analyzed with 2 commercially available dipsticks. Two observers evaluated each result blinded to the other observer and to the results of the other dipstick. Intra- and inter-assay variability was assessed in 5 samples (corresponding to the 5 different semi-quantitative results) tested 10 consecutive times over 5 consecutive days. The agreement between observers and between dipsticks was evaluated with Cohen's k test. RESULTS Intra-assay repeatability was good (≤3/10 errors), whereas inter-assay variability was higher (from 1/5 to 4/5 discordant results). The concordance between the operators (k = 0.68 and 0.79 for the 2 dipsticks) and that of the dipsticks (k = 0.66 and 0.74 for the 2 operators) was good. However, 1 observer and 1 dipstick overestimated the results compared with the second observer or dipstick. In any case, discordant results accounted for a single unit of the semi-quantitative scale. CONCLUSIONS As for any other method, analytic variability may affect the semi-quantitation of urinary proteins when using the dipstick method. Subjective interpretation of the pad and, to a lesser extent, intrinsic staining properties of the pads could affect the results. Further studies are warranted to evaluate the effect of this variability on clinical decisions.
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Affiliation(s)
- Marco Giraldi
- Department of Veterinary Medicine, University of Milan, Milan, Italy.,Veterinary Teaching Hospital, University of Milan, Lodi, Italy
| | - Saverio Paltrinieri
- Department of Veterinary Medicine, University of Milan, Milan, Italy.,Veterinary Teaching Hospital, University of Milan, Lodi, Italy
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19
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Ferlizza E, Dondi F, Andreani G, Bucci D, Archer J, Isani G. Validation of an electrophoretic method to detect albuminuria in cats. J Feline Med Surg 2017; 19:860-868. [PMID: 27555488 PMCID: PMC11104127 DOI: 10.1177/1098612x16664112] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Objectives The aims of this study were to validate a semi-automated high-resolution electrophoretic technique to quantify urinary albumin in healthy and diseased cats, and to evaluate its diagnostic performance in cases of proteinuria and renal diseases. Methods Urine samples were collected from 88 cats (healthy; chronic kidney disease [CKD]; lower urinary tract disease [LUTD]; non-urinary tract diseases [OTHER]). Urine samples were routinely analysed and high-resolution electrophoresis (HRE) was performed. Within-assay and between-assay variability, linearity, accuracy, recovery and the lowest detectable and quantifiable bands were calculated. Receiver operating curve (ROC) analysis was also performed. Results All coefficients of variation were <10%, percentage recovery was between 97% and 109% with a high linearity (r = 0.99). HRE allowed the visualisation of a faint band of albumin and a diffused band between alpha and beta zones in healthy cats, while profiles from diseased cats were variable. Albumin (mg/dl) and urine albumin:creatinine ratio (UAC) were significantly ( P <0.05) different between healthy and diseased cats. After ROC analysis, UAC values of 0.035 and 0.074 had a high sensitivity and high specificity, respectively, to classify proteinuria and identify borderline proteinuric cats. Moreover, a UAC of 0.017 had a high sensitivity in distinguishing between healthy and diseased cats. However, UAC was not able to distinguish between renal (CKD) and non-renal diseases (LUTD/OTHER), probably owing to the pathophysiology of CKD in cats, which is characterised by low-grade proteinuria and less glomerular involvement than in dogs. Conclusions and relevance HRE is an accurate and precise method that could be used to measure albuminuria in cats. UAC was useful to correctly classify proteinuria and to discriminate between healthy and diseased cats. HRE might also provide additional information on urine proteins with a profile of all proteins (albumin and globulins) to aid clinicians in the diagnosis of diseases characterised by proteinuria.
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Affiliation(s)
- Enea Ferlizza
- Department of Veterinary Medical Sciences, University of Bologna, Ozzano, Italy
| | - Francesco Dondi
- Department of Veterinary Medical Sciences, University of Bologna, Ozzano, Italy
| | - Giulia Andreani
- Department of Veterinary Medical Sciences, University of Bologna, Ozzano, Italy
| | - Diego Bucci
- Department of Veterinary Medical Sciences, University of Bologna, Ozzano, Italy
| | - Joy Archer
- Department of Veterinary Medicine, University of Cambridge, Cambridge, UK
| | - Gloria Isani
- Department of Veterinary Medical Sciences, University of Bologna, Ozzano, Italy
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20
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Marynissen S, Willems A, Paepe D, Smets P, Picavet P, Duchateau L, Daminet S. Proteinuria in Apparently Healthy Elderly Dogs: Persistency and Comparison Between Free Catch and Cystocentesis Urine. J Vet Intern Med 2017; 31:93-101. [PMID: 28019038 PMCID: PMC5259622 DOI: 10.1111/jvim.14635] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2016] [Revised: 08/10/2016] [Accepted: 11/15/2016] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Up to 25% of elderly humans have proteinuria, often associated with underlying lesions. Data concerning the presence of proteinuria in elderly dogs is scarce. OBJECTIVES To describe the presence and persistence of proteinuria and to compare urinary protein : creatinine ratio (UPC) between free catch and cystocentesis urine samples in apparently healthy elderly dogs. ANIMALS Hundred apparently healthy elderly dogs. METHODS Prospective study. Owners of 100 elderly dogs were asked to collect 2 free catch urine samples. Dogs were considered healthy based on owner's perception and an age chart, based on ideal bodyweight, was used to define dogs as senior or geriatric. UPC of urine collected by free catch and cystocentesis were compared. Overt proteinuria and borderline proteinuria were defined as UPC >0.5 and between 0.2 and 0.5, respectively, if examination of sediment did not explain proteinuria. Proteinuria was considered persistent if present at both sampling times. RESULTS At baseline, 71 owners succeeded in collecting urine. Eleven percent of dogs had overt proteinuria, 14% were borderline proteinuric, and 75% nonproteinuric. Thirty-seven repeated urine samples, with a median time interval of 31 days (range 10-90), were available. Nineteen percent of dogs had a persistently increased UPC (>0.2), with persistent overt proteinuria present in 8%. A strong correlation (ρ = 0.88) was found between UPC of urine collected by free catch and cystocentesis. CONCLUSIONS AND CLINICAL IMPORTANCE As 19% of study dogs had persistent proteinuria, our findings emphasize that measurement of proteinuria should be part of geriatric health screening. For UPC in dogs, free catch urine provides a good alternative to cystocentesis.
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Affiliation(s)
- S.J.J. Marynissen
- Department of Medicine and Clinical Biology of Small AnimalsFaculty of Veterinary MedicineGhent UniversityMerelbekeBelgium
| | - A.L. Willems
- Department of Medicine and Clinical Biology of Small AnimalsFaculty of Veterinary MedicineGhent UniversityMerelbekeBelgium
| | - D. Paepe
- Department of Medicine and Clinical Biology of Small AnimalsFaculty of Veterinary MedicineGhent UniversityMerelbekeBelgium
| | - P.M.Y. Smets
- Department of Medicine and Clinical Biology of Small AnimalsFaculty of Veterinary MedicineGhent UniversityMerelbekeBelgium
| | - P. Picavet
- Hill's Pet Nutrition, IncMerelbekeBelgium
| | - L. Duchateau
- Department of Comparative Physiology and BiometricsFaculty of Veterinary MedicineGhent UniversityMerelbekeBelgium
| | - S. Daminet
- Department of Medicine and Clinical Biology of Small AnimalsFaculty of Veterinary MedicineGhent UniversityMerelbekeBelgium
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21
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Busin V, Wells B, Kersaudy-Kerhoas M, Shu W, Burgess STG. Opportunities and challenges for the application of microfluidic technologies in point-of-care veterinary diagnostics. Mol Cell Probes 2016; 30:331-341. [PMID: 27430150 DOI: 10.1016/j.mcp.2016.07.004] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2016] [Revised: 07/14/2016] [Accepted: 07/14/2016] [Indexed: 11/17/2022]
Abstract
There is a growing need for low-cost, rapid and reliable diagnostic results in veterinary medicine. Point-of-care (POC) tests have tremendous advantages over existing laboratory-based tests, due to their intrinsic low-cost and rapidity. A considerable number of POC tests are presently available, mostly in dipstick or lateral flow formats, allowing cost-effective and decentralised diagnosis of a wide range of infectious diseases and public health related threats. Although, extremely useful, these tests come with some limitations. Recent advances in the field of microfluidics have brought about new and exciting opportunities for human health diagnostics, and there is now great potential for these new technologies to be applied in the field of veterinary diagnostics. This review appraises currently available POC tests in veterinary medicine, taking into consideration their usefulness and limitations, whilst exploring possible applications for new and emerging technologies, in order to widen and improve the range of POC tests available.
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Affiliation(s)
- Valentina Busin
- Moredun Research Institute, Pentlands Science Park, Bush Loan, Edinburgh, EH26 0PZ, United Kingdom; School of Engineering and Physical Sciences, Heriot-Watt University, Edinburgh, EH14 4AS, United Kingdom.
| | - Beth Wells
- Moredun Research Institute, Pentlands Science Park, Bush Loan, Edinburgh, EH26 0PZ, United Kingdom.
| | - Maïwenn Kersaudy-Kerhoas
- School of Engineering and Physical Sciences, Heriot-Watt University, Edinburgh, EH14 4AS, United Kingdom.
| | - Wenmaio Shu
- School of Engineering and Physical Sciences, Heriot-Watt University, Edinburgh, EH14 4AS, United Kingdom; Department of Biomedical Engineering, University of Strathclyde, Glasgow, G4 0NW, United Kingdom.
| | - Stewart T G Burgess
- Moredun Research Institute, Pentlands Science Park, Bush Loan, Edinburgh, EH26 0PZ, United Kingdom.
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22
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Sparkes AH, Caney S, Chalhoub S, Elliott J, Finch N, Gajanayake I, Langston C, Lefebvre HP, White J, Quimby J. ISFM Consensus Guidelines on the Diagnosis and Management of Feline Chronic Kidney Disease. J Feline Med Surg 2016; 18:219-39. [PMID: 26936494 PMCID: PMC11148907 DOI: 10.1177/1098612x16631234] [Citation(s) in RCA: 99] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/27/2024]
Abstract
PRACTICAL RELEVANCE Chronic kidney disease (CKD) is one of the most commonly diagnosed diseases in older cats. In most cats, CKD is also a progressive disease and can be accompanied by a wide range of clinical and clinicopathological changes. These ISFM Consensus Guidelines have been developed by an independent panel of clinicians and academics to provide practical advice on the diagnosis and management of this complex disease. CLINICAL CHALLENGES Although CKD is a common clinical problem in cats, the manifestations of disease vary between individuals. Thus there is a need for careful and repeat evaluation of cats with CKD and adjustment of therapy according to individual needs. In addition to addressing problems arising from CKD and improving quality of life (QoL) for the patient, therapy may also target slowing the underlying progression of disease and hence prolonging life. While maintaining QoL is of paramount importance in our patients, this can be challenging when multiple therapies are indicated. In some cases it is necessary to prioritise therapy, given an understanding of what is likely to most benefit the individual patient. EVIDENCE BASE In preparing these Guidelines, the Panel has carefully reviewed the existing published literature, and has also graded the quality of evidence for different interventions to help to provide practical recommendations on the therapeutic options for feline CKD. This is a field of veterinary medicine that has benefited from some excellent published clinical research and further research findings will undoubtedly modify the recommendations contained in these Guidelines in the future.
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Affiliation(s)
| | | | - Serge Chalhoub
- Faculty of Veterinary Medicine, University of Calgary, Canada
| | - Jonathan Elliott
- Department of Comparative Biomedical Sciences, Royal Veterinary College, UK
| | - Natalie Finch
- Bristol Renal, School of Clinical Sciences, University of Bristol, UK
| | | | | | - Hervé P Lefebvre
- Clinical Research Unit, National Veterinary School of Toulouse (ENVT), France
| | - Joanna White
- Small Animal Specialist Hospital, Sydney, Australia
| | - Jessica Quimby
- Department of Clinical Veterinary Sciences, Colorado State University, USA
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23
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Williams TL, Archer J. Evaluation of urinary biomarkers for azotaemic chronic kidney disease in cats. J Small Anim Pract 2015; 57:122-9. [DOI: 10.1111/jsap.12439] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2015] [Revised: 08/27/2015] [Accepted: 09/21/2015] [Indexed: 11/26/2022]
Affiliation(s)
- T. L. Williams
- Department of Veterinary Medicine; University of Cambridge; Madingley Road Cambridge CB3 0ES
| | - J. Archer
- Department of Veterinary Medicine; University of Cambridge; Madingley Road Cambridge CB3 0ES
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24
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Scansen BA, Vitt J, Chew DJ, Schober KE, Bonagura JD. Comparison of forelimb and hindlimb systolic blood pressures and proteinuria in healthy Shetland Sheepdogs. J Vet Intern Med 2014; 28:277-83. [PMID: 24433302 PMCID: PMC4858003 DOI: 10.1111/jvim.12289] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2013] [Revised: 08/01/2013] [Accepted: 11/25/2013] [Indexed: 11/29/2022] Open
Abstract
Background The prevalence of systemic hypertension (SHT) in Shetland Sheepdogs has not been reported. Hypothesis/Objectives SHT is common in Shetland Sheepdogs and positively correlated with proteinuria. Measurements of forelimb and hindlimb systolic arterial pressure (SAP) are comparable. Animals Seventy‐two clinically healthy, client‐owned Shetland Sheepdogs. Methods Forelimb and hindlimb SAP were recorded by Doppler ultrasonography. Proteinuria was quantified by urine dipstick, microalbuminuria, and protein:creatinine ratio (UPC). The relationship of UPC, anxiety, age, weight, and heart rate with forelimb SAP was evaluated. Results The mean forelimb and hindlimb SAP were 132 ± 20 and 118 ± 20 mmHg, respectively. The SAP exceeded 160 mmHg in 9 dogs, suggesting 13% prevalence of SHT. Four dogs had a UPC above 0.5; 2 of these had forelimb SAP exceeding 160 mmHg. Correlation of forelimb and hindlimb SAP was poor (r2 = 0.09; P = .011). Bland–Altman plots revealed substantial bias (−14 mmHg) between limb measurements with clinically unacceptable 95% limits of agreement (−60 to 33 mmHg). There was no correlation between forelimb SAP and UPC (P = .06) or anxiety level (P = .49). Age (P < .0001) and heart rate (P = .038) were significant predictors of forelimb SAP; weight (P = .73) was not. Conclusions Prevalence of SHT was 13% and not correlated with proteinuria. Forelimb and hindlimb SAP were poorly correlated; therefore, trends in an individual animal should be monitored using the same measurement site. Additionally, values for Doppler SAP were determined in Shetland Sheepdogs.
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Affiliation(s)
- B A Scansen
- Department of Veterinary Clinical Sciences, The Ohio State University College of Veterinary Medicine, Columbus, OH
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Abstract
PRACTICAL RELEVANCE Feline chronic kidney disease (CKD) is frequently encountered by veterinarians. Timely diagnosis and staging may facilitate the initiation of adequate therapy and improve the prognosis for patients. CLINICAL CHALLENGES Feline CKD is diagnosed based on the presence of compatible clinical signs and renal azotaemia, which implies that urinalysis (particularly urine specific gravity) is mandatory to confirm the diagnosis. Although the diagnosis of advanced feline CKD and associated complications is usually straightforward, based on complete blood and urine examination, all routine blood and urine tests have their limitations in detecting early CKD. Therefore, diagnosing early or non-azotaemic CKD is much more challenging. Although determination of glomerular filtration rate (GFR) would be ideal to identify early kidney dysfunction, practical limitations hamper its routine use in clinical practice. PATIENT GROUP CKD is typically a disease of aged cats, but may affect cats of all ages. Conclusive breed and sex predispositions for feline CKD are not reported. AUDIENCE This review is directed at practising veterinarians and provides an overview of the required diagnostic tests, the classification system established by the International Renal Interest Society, and the importance of and possible techniques for early detection of CKD. EVIDENCE BASE Staging of cats with CKD is essential as it directs management and provides a prognostic guide. Given that diagnosis at early disease stages is associated with more prolonged survival times, simple, inexpensive and accurate methods for early CKD diagnosis are needed. Techniques currently under investigation include limited sampling strategies to estimate GFR, clearance marker cut-off concentrations to identify cats with low GFR, new indirect GFR markers and urinary biomarkers.
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Affiliation(s)
- Dominique Paepe
- Department of Small Animal Medicine and Clinical Biology, Faculty of Veterinary Medicine, Ghent University, Salisburylaan 133, B-9820 Merelbeke, Belgium.
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De Loor J, Daminet S, Smets P, Maddens B, Meyer E. Urinary biomarkers for acute kidney injury in dogs. J Vet Intern Med 2013; 27:998-1010. [PMID: 23952327 DOI: 10.1111/jvim.12155] [Citation(s) in RCA: 59] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2012] [Revised: 05/23/2013] [Accepted: 07/10/2013] [Indexed: 11/29/2022] Open
Abstract
Routinely, kidney dysfunction and decreased glomerular filtration rate (GFR) are diagnosed by the evaluation of changes in the serum creatinine (SCr) and blood urea nitrogen (BUN) concentrations. However, neither of these tests is sensitive or specific enough for the early diagnosis of impaired kidney function because they are both affected by other renal and nonrenal factors. Furthermore, kidney injury can be present in the absence of kidney dysfunction. Renal reserve enables normal GFR even when nephrons are damaged. Renal biomarkers, especially those present in urine, may be useful for the study of both acute and chronic nephropathies. The aim of this review is to describe the current status of urinary biomarkers as diagnostic tools for kidney injury in dogs with particular focus on acute kidney injury (AKI). The International Renal Interest Society (IRIS) canine AKI grading system and the implementation of urinary biomarkers in this system also are discussed. The discovery of novel urinary biomarkers has emerged from hypotheses about the pathophysiology of kidney injury, but few proteomic urine screening approaches have been described in dogs. Lack of standardization of biomarker assays further complicates the comparison of novel canine urinary biomarker validation results among studies. Future research should focus on novel biomarkers of renal origin and evaluate promising biomarkers in different clinical conditions. Validation of selected urinary biomarkers in the diagnosis of canine kidney diseases must include dogs with both renal and nonrenal diseases to evaluate their sensitivity, specificity as well as their negative and positive predictive values.
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Affiliation(s)
- J De Loor
- Department of Pharmacology, Toxicology and Biochemistry, Ghent University, Merelbeke, Belgium
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Bloom CA, Rand JS. Diabetes and the Kidney in Human and Veterinary Medicine. Vet Clin North Am Small Anim Pract 2013; 43:351-65. [DOI: 10.1016/j.cvsm.2012.11.002] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Hanzlicek AS, Roof CJ, Sanderson MW, Grauer GF. Comparison of urine dipstick, sulfosalicylic acid, urine protein-to-creatinine ratio and a feline-specific immunoassay for detection of albuminuria in cats with chronic kidney disease. J Feline Med Surg 2012; 14:882-8. [PMID: 22802340 PMCID: PMC11108021 DOI: 10.1177/1753193412454519] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/10/2024]
Abstract
The performance of the urine dipstick, sulfosalicylic acid (SSA), and urine protein-to-creatinine (UPC) tests for the detection of albuminuria was assessed in cats with chronic kidney disease (CKD). Two hundred and thirty-nine urine samples from 37 cats with CKD were used. Test results were dichotomized as either positive or negative, compared with those for the feline-specific rapid urine albumin immunoassay and test performance variables calculated for each test. A positive urine dipstick (≥ trace) and positive SSA (≥ 5 mg/dl), positive SSA alone or ≥ 2+ urine dipstick alone were indicative of albuminuria. In these cases, protein quantification would be warranted if proteinuria/albuminuria is persistent. In the case of a negative urine dipstick result the addition of the SSA added little diagnostic value. Of the tests investigated, the single best test for the detection of albuminuria was the UP/C (≥ 0.2) in which either a negative or positive test result provided useful information.
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Affiliation(s)
- Andrew S Hanzlicek
- Department of Veterinary Clinical Sciences, Center for Veterinary Health Sciences, Oklahoma State University, Stillwater, OK 74078, USA.
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Al-Ghazlat SA, Langston CE, Greco DS, Reine NJ, May SN, Shofer FS. The Prevalence of Microalbuminuria and Proteinuria in Cats with Diabetes Mellitus. Top Companion Anim Med 2011; 26:154-7. [DOI: 10.1053/j.tcam.2011.04.005] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Atkins C, Vaden S, Arther R, Ciszewski D, Davis W, Ensley S, Chopade N. Renal effects of Dirofilaria immitis in experimentally and naturally infected cats. Vet Parasitol 2011; 176:317-23. [DOI: 10.1016/j.vetpar.2011.01.016] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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