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Ito T, Hanazono K, Miyoshi K, Endoh D. Evaluation of renal function in dogs using pulsed Doppler ultrasonography. Open Vet J 2024; 14:3449-3459. [PMID: 39927338 PMCID: PMC11799656 DOI: 10.5455/ovj.2024.v14.i12.29] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2024] [Accepted: 11/07/2024] [Indexed: 02/11/2025] Open
Abstract
Background In human medicine, efforts have been made to evaluate venous blood flow in the kidneys to diagnose renal disease and estimate renal function. In dogs, previous studies have predicted renal function using the resistive index (RI) and pulsatility index (PI), which are derived from renal arterial blood flow velocity assessed via pulsed Doppler ultrasonography. However, to date, no study has been conducted on renal venous blood flow velocity in dogs. Aim To investigate the relationship between renal venous blood flow velocity and renal function. Methods Ten normal beagle dogs underwent blood tests and glomerular filtration rate (GFR) measurements. Pulsed Doppler ultrasonography was performed under sedation to measure the maximum venous flow velocity (Vmax), minimum venous flow velocity (Vmin), and venous impedance index in the renal and interlobular veins. The RI and PI were calculated from the renal and interlobular arteries. Results Vmax and Vmin of the renal vein were negatively correlated with GFR in both kidneys. No significant correlations were found between other measures and GFR. These results suggest a relationship between GFR and venous flow velocity in the renal veins assessed using pulsed Doppler ultrasonography. Conclusion These findings demonstrate the potential of this methodology as a new tool for predicting abnormalities in the renal venous blood flow and renal congestion in dogs. Further large-scale studies and comparisons between healthy dogs and dogs with impaired renal function are needed to validate this relationship.
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Affiliation(s)
- Takami Ito
- School of Veterinary Medicine, Rakuno Gakuen University, Ebetsu, Japan
| | - Kiwamu Hanazono
- School of Veterinary Medicine, Rakuno Gakuen University, Ebetsu, Japan
| | - Kenjirou Miyoshi
- School of Veterinary Medicine, Rakuno Gakuen University, Ebetsu, Japan
| | - Daiji Endoh
- School of Veterinary Medicine, Rakuno Gakuen University, Ebetsu, Japan
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Pantaleo V, Furlanello T, Carli E, Ventura L, Solano-Gallego L. Evaluation of urinary podocin and nephrin as markers of podocyturia in dogs with leishmaniosis. Parasit Vectors 2024; 17:423. [PMID: 39380100 PMCID: PMC11462908 DOI: 10.1186/s13071-024-06510-3] [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: 08/12/2024] [Accepted: 09/26/2024] [Indexed: 10/10/2024] Open
Abstract
BACKGROUND Renal disease is the main cause of death in canine leishmaniosis. Detection of an active glomerular injury is important to identify early renal damage and to prevent the development of chronic kidney disease. Podocyturia can indicate renal injury, and podocyte-associated molecules such as podocin and nephrin can be used to identify podocyturia. The purpose of the study was to evaluate urinary podocin and nephrin concentrations in dogs with leishmaniosis as markers of podocyturia. METHODS A total of 35 healthy dogs and 37 dogs with leishmaniosis were enrolled in the study. Dogs with leishmaniosis were classified according to the staging of the International Renal Interest Society (IRIS). Urinary podocin and nephrin concentrations were measured in all dogs with a validated enzyme-linked immunosorbent assay test and normalized to creatinine (uPoC and uNeC, respectively). The demographic, clinical, and laboratory data from both groups were analyzed and compared. Subsequently, the laboratory results were analyzed and compared according to IRIS staging in dogs in IRIS stage I and dogs in IRIS stage II + III + IV. The Pearson's correlation test evaluated the relationship between urinary markers of podocyturia. RESULTS Compared with healthy dogs, lower urinary podocin [median values (IQR): 15.10 (11.75-17.87) ng/ml versus 8.63 (7.08-13.56) ng/ml; P < 0.01] and nephrin [median values (IQR): 3.2 (3.62-5.43) ng/ml versus 2.67 (2.06-3.44) ng/ml; P < 0.01] were found in infected sick dogs. No significant differences were observed in the uPoC and uNeC between the two groups. Urinary nephrin and podocin concentrations were higher in healthy dogs and in dogs in IRIS stage I (both P < 0.05) compared with dogs in IRIS stages II + III + IV. No significant differences were found for uPoC and uNeC between healthy dogs and dogs with leishmaniosis in different IRIS clinical stages. CONCLUSIONS Dogs with leishmaniosis had a low concentration of podocin and nephrin in more advanced IRIS clinical stages, when kidney disease was more severe compared with healthy dogs and dogs in IRIS stage I with mild disease. Urinary nephrin was detectable for the first time in healthy non-infected dogs.
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Affiliation(s)
- Valeria Pantaleo
- San Marco Veterinary Clinic and Laboratory, Veggiano, Padua, Italy
- Departament de Medicina i Cirurgia Animals, Universitat Autònoma de Barcelona, Bellaterra, Barcelona, Spain
| | | | - Erika Carli
- San Marco Veterinary Clinic and Laboratory, Veggiano, Padua, Italy
| | - Laura Ventura
- Department of Statistical Sciences, University of Padova, Padua, Italy
| | - Laia Solano-Gallego
- Departament de Medicina i Cirurgia Animals, Universitat Autònoma de Barcelona, Bellaterra, Barcelona, Spain.
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Fulton EA, McBrearty AR, Shaw DJ, Ridyard AE. Response and survival of dogs with proteinuria (UPC > 2.0) treated with angiotensin converting enzyme inhibitors. J Vet Intern Med 2023; 37:2188-2199. [PMID: 37815154 PMCID: PMC10658551 DOI: 10.1111/jvim.16864] [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: 11/29/2022] [Accepted: 08/24/2023] [Indexed: 10/11/2023] Open
Abstract
BACKGROUND Angiotensin-converting enzyme inhibitors (ACEi) are a recommended treatment for glomerular proteinuria. Frequency of response to ACEi and the association of achieving proposed urine protein-to-creatinine ratio (UPC) targets on survival is unknown. OBJECTIVES To determine response rates to ACEi therapy and whether a positive response is associated with improved survival. ANIMALS Eighty-five dogs with proteinuria (UPC > 2.0). METHODS Retrospective study including dogs (UPC > 2.0) prescribed an ACEi for treatment of proteinuria. Baseline creatinine, albumin, cholesterol, UPC, and systolic blood pressure were recorded, and cases reviewed to track UPC. Treatment response was defined as achieving a UPC of <0.5 or reduction of ≥50% from baseline within 3 months. Outcome data were collected to determine overall and 12-month survival. RESULTS Thirty-five (41%) dogs responded to ACEi treatment. Treatment response was statistically associated with both median survival time (664 days [95% confidence interval (CI): 459-869] for responders compared to 177 [95% CI: 131-223] for non-responders) and 12-month survival (79% responders alive compared to 28% non-responders). Baseline azotemia or hypoalbuminemia were also associated with a worse prognosis, with odds ratios of death at 12 months of 5.34 (CI: 1.85-17.32) and 4.51 (CI: 1.66-13.14), respectively. In the 25 dogs with normal baseline creatinine and albumin, response to treatment was associated with 12-month survival (92% responders alive compared to 54% non-responders, P = .04). CONCLUSIONS AND CLINICAL IMPORTANCE When the UPC is >2.0, achieving recommended UPC targets within 3 months appears to be associated with a significant survival benefit. Response to treatment is still associated with survival benefit in dogs with less severe disease (no azotemia or hypoalbuminemia).
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Affiliation(s)
- Emily A. Fulton
- The University of Glasgow Small Animal Hospital, School of Biodiversity, One Health and Veterinary Medicine, 464 Bearsden RoadGlasgow G61 1QHUnited Kingdom
| | - Alix R. McBrearty
- VetsNow Hospital Glasgow, 123‐145 North StreetGlasgow G3 7DAUnited Kingdom
| | - Darren J. Shaw
- Royal (Dick) School of Veterinary Studies, The University of Edinburgh, Easter Bush CampusRoslin EH25 9RGUnited Kingdom
| | - Alison E. Ridyard
- The University of Glasgow Small Animal Hospital, School of Biodiversity, One Health and Veterinary Medicine, 464 Bearsden RoadGlasgow G61 1QHUnited Kingdom
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Cavalera MA, Gernone F, Uva A, Donghia R, Zizzadoro C, Zatelli A. Efficacy of domperidone plus renal diet in slowing the progression of chronic kidney disease in dogs with leishmaniosis. Parasit Vectors 2022; 15:397. [PMID: 36316751 PMCID: PMC9620618 DOI: 10.1186/s13071-022-05537-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Accepted: 10/06/2022] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Chronic kidney disease (CKD) represents the main cause of mortality in dogs with leishmaniosis. Domperidone has recently been reported to improve kidney function in leishmaniotic dogs affected by CKD. Serum symmetric dimethylarginine (sSDMA) has also been shown to be a useful biomarker for earlier detection of decreased kidney function when compared to serum creatinine (sCr). This study aimed to assess the efficacy of domperidone plus renal diet in slowing the progression of nephropathy in leishmaniotic dogs with CKD, evaluating sSDMA and sCr as markers of kidney function. METHODS This study was a therapeutic, prospective, randomized, controlled, 11-month-long field trial. Dogs were recruited if classified as "exposed" to or "infected" with Leishmania infantum and affected by CKD at early stages. After enrolment (T0), dogs were randomized into groups T (treatment) and C (control). All dogs were fed a renal diet and then followed up at 90 (T1), 210 (T2), and 330 (T3) days after inclusion in the study. At T1 and T2, dogs in group T received an oral suspension of domperidone (1 ml/10 kg once a day for up to 28 days). RESULTS Twenty-two dogs (i.e., n = 12 in group T and n = 10 in group C) completed the study. At T0, the entire population of enrolled dogs presented a mean sSDMA value of 16.5 ± 3.4 μg/dl. At T1 (i.e., after 3 months of renal diet), sSDMA was significantly decreased in both groups, with an sSDMA of 13.1 ± 4.4 μg/dl for the entire population involved. From T1 to T3, sSDMA gradually increased in group C, while remaining stable in group T, which continued to show a significantly lower value of sSDMA at T3 than at T0. Regarding sCr, at T0 and T1, the mean values of the entire population of dogs were 1.1 ± 0.3 and 1.0 ± 0.4 mg/dl, respectively, with no statistical differences between groups T and C. In group T, sCr decreased significantly from T0 to T1, while returning at T3 to values similar to T0. CONCLUSIONS In this study, domperidone plus renal diet reduced the progression of kidney disease in leishmaniotic dogs affected by CKD.
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Affiliation(s)
| | - Floriana Gernone
- Department of Veterinary Medicine, University of Bari, Valenzano, Italy
| | - Annamaria Uva
- Department of Veterinary Medicine, University of Bari, Valenzano, Italy
| | - Rossella Donghia
- Unit of Research Methodology and Data Sciences for Population Health, “Salus in Apulia Study” National Institute of Gastroenterology “S. de Bellis” Research Hospital, Bari, Italy
| | - Claudia Zizzadoro
- Department of Veterinary Medicine, University of Bari, Valenzano, Italy
| | - Andrea Zatelli
- Department of Veterinary Medicine, University of Bari, Valenzano, Italy
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Miyakawa H, Hsu HH, Ogawa M, Akabane R, Miyagawa Y, Takemura N. Association between serum fibroblast growth factor-23 concentration and development of hyperphosphatemia in normophosphatemic dogs with chronic kidney disease. J Vet Intern Med 2021; 35:2296-2305. [PMID: 34418162 PMCID: PMC8478064 DOI: 10.1111/jvim.16237] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2021] [Revised: 07/22/2021] [Accepted: 07/22/2021] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Fibroblast growth factor (FGF)-23 is increased first in the sequence of changes associated with chronic kidney disease (CKD)-mineral and bone disorder. Thus, its measurement may serve as a predictive indicator of incident hyperphosphatemia. OBJECTIVES To investigate whether serum FGF-23 concentration in normophosphatemic dogs with CKD is associated with the risk of the subsequent development of hyperphosphatemia and CKD progression. ANIMALS Forty-two normophosphatemic dogs with CKD. METHODS Blood samples and medical records were retrospectively investigated. Hyperphosphatemia was defined as a serum phosphorous concentration >5.0 mg/dL. Progression was defined as a >1.5-fold increase in serum creatinine concentration. The time periods and hazard ratios for these outcomes were assessed using Kaplan-Meier analysis, log-rank test, and univariate Cox regression analysis. The variables associated with the outcomes in the univariate analysis were included in the multivariate Cox regression model with backward selection. RESULTS Serum FGF-23 concentration >528 pg/mL was associated with a shorter time to development of hyperphosphatemia (P < .001) and CKD progression (P < .001). In multiple Cox regression analysis, increased FGF-23 concentration remained a significant variable associated with these outcomes (P < .05). CONCLUSIONS AND CLINICAL IMPORTANCE Increased FGF-23 concentration in normophosphatemic dogs with CKD was associated with significant risk of development of hyperphosphatemia, independent of CKD stage, and of the progression of CKD. Future research focusing on whether interventions that decrease FGF-23 secretion will slow the development of hyperphosphatemia and CKD progression is needed.
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Affiliation(s)
- Hirosumi Miyakawa
- Laboratory of Veterinary Internal Medicine II, Nippon Veterinary and Life Science University, Tokyo, Japan
| | - Huai-Hsun Hsu
- Laboratory of Veterinary Internal Medicine II, Nippon Veterinary and Life Science University, Tokyo, Japan
| | - Mizuki Ogawa
- Laboratory of Veterinary Internal Medicine II, Nippon Veterinary and Life Science University, Tokyo, Japan
| | - Ryota Akabane
- Laboratory of Veterinary Internal Medicine II, Nippon Veterinary and Life Science University, Tokyo, Japan
| | - Yuichi Miyagawa
- Laboratory of Veterinary Internal Medicine II, Nippon Veterinary and Life Science University, Tokyo, Japan
| | - Naoyuki Takemura
- Laboratory of Veterinary Internal Medicine II, Nippon Veterinary and Life Science University, Tokyo, Japan
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Perini-Perera S, Del-Ángel-Caraza J, Pérez-Sánchez AP, Quijano-Hernández IA, Recillas-Morales S. Evaluation of Chronic Kidney Disease Progression in Dogs With Therapeutic Management of Risk Factors. Front Vet Sci 2021; 8:621084. [PMID: 34026884 PMCID: PMC8131674 DOI: 10.3389/fvets.2021.621084] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2020] [Accepted: 02/27/2021] [Indexed: 11/24/2022] Open
Abstract
This research was performed to describe the characteristics of the progression of naturally occurring chronic kidney disease (CKD) in dogs, together with the management of identified risk factors, following the International Renal Interest Society recommendations. Dogs diagnosed and staged with CKD, and with a longitudinal follow-up from the moment of diagnosis of up to a maximum of 730 days, were included. A total of 545 dogs that presented risk factors for the development of CKD were analyzed, out of which 36 met the inclusion criteria. Advanced age was identified in 80.6% of cases. Initiation risk factors were represented by inflammatory/infectious diseases, history of anesthetic-surgical procedures, heart disease, neoplasms, endocrinopathies, and exposure to nephrotoxic drugs. During the follow-up period, progression of CKD was identified in 47.2% of the cases, being more salient in advanced stages. Serum symmetric dimethyl arginine (SDMA) was the only glomerular filtration rate (GFR) marker which displayed differences among studied times during early stages of CKD, associated with the disease progression and decline of renal function. A significant difference between the survival curves in early and advanced CKD stages was observed. The factors related to decreased survival were hyperphosphatemia, anemia, and low body condition score (BCS). No differences were found between the presence of arterial hypertension and renal proteinuria and decreased survival. Furthermore, CKD diagnosis based on the persistent finding of abnormalities in early disease markers, such as serum symmetric dimethyl arginine increase and/or renal proteinuria, and timely therapeutic management of risk factors, allowed for CKD stabilization, reducing progression to advanced stages, and favoring higher survival rates.
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Affiliation(s)
- Sofía Perini-Perera
- Facultad de Medicina Veterinaria y Zootecnia, Hospital Veterinario para Pequeñas Especies, Universidad Autónoma del Estado de Mexico, Toluca, Mexico
| | - Javier Del-Ángel-Caraza
- Facultad de Medicina Veterinaria y Zootecnia, Hospital Veterinario para Pequeñas Especies, Universidad Autónoma del Estado de Mexico, Toluca, Mexico
| | - Alicia Pamela Pérez-Sánchez
- Facultad de Medicina Veterinaria y Zootecnia, Hospital Veterinario para Pequeñas Especies, Universidad Autónoma del Estado de Mexico, Toluca, Mexico
| | - Israel Alejandro Quijano-Hernández
- Facultad de Medicina Veterinaria y Zootecnia, Hospital Veterinario para Pequeñas Especies, Universidad Autónoma del Estado de Mexico, Toluca, Mexico
| | - Sergio Recillas-Morales
- Facultad de Medicina Veterinaria y Zootecnia, Universidad Autónoma del Estado de Mexico, Toluca, Mexico
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Roura X, Cortadellas O, Day MJ, Benali SL, Zatelli A. Canine leishmaniosis and kidney disease: Q&A for an overall management in clinical practice. J Small Anim Pract 2020; 62:E1-E19. [PMID: 33107613 DOI: 10.1111/jsap.13237] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2020] [Accepted: 09/10/2020] [Indexed: 12/19/2022]
Affiliation(s)
- X Roura
- Hospital Clínic Veterinari, Universitat Autònoma de Barcelona, 08193, Bellaterra, Spain
| | - O Cortadellas
- Hospital Clínico Veterinario, Universidad CEU Cardenal Herrera, 46115, Valencia, Spain
| | - M J Day
- School of Veterinary and Life Sciences, Murdoch University, 6150, Murdoch, Australia
| | - S L Benali
- Laboratorio La Vallonea, 20017, Milano, Italy
| | | | - A Zatelli
- Dipartimento di Medicina Veterinaria, Università degli Studi di Bari "Aldo Moro", 70010, Bari, Italy
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Miyagawa Y, Akabane R, Sakatani A, Ogawa M, Nagakawa M, Miyakawa H, Takemura N. Effects of telmisartan on proteinuria and systolic blood pressure in dogs with chronic kidney disease. Res Vet Sci 2020; 133:150-156. [PMID: 32992126 DOI: 10.1016/j.rvsc.2020.09.019] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2020] [Revised: 09/16/2020] [Accepted: 09/17/2020] [Indexed: 10/23/2022]
Abstract
Renal proteinuria is associated with promoted renal dysfunction and a shorter survival period in dogs with chronic kidney disease (CKD). Renin angiotensin- aldosterone system inhibitors are primarily used to treat renal proteinuria. In this retrospective, open-label study, we aimed to evaluate the anti-proteinuric and anti-hypertensive effects of telmisartan (angiotensin II receptor blocker) in dogs with proteinuric CKD. A total of 28 dogs with proteinuric CKD were included in the study, all dogs received telmisartan 1 mg/kg q24h, PO. The urine protein-to-creatinine ratio (UPC), urine albumin-to-creatinine ratio (UAC) and systolic blood pressure (SBP) decreased significantly after telmisartan administration (P < 0.05). The median rate of change in UPC, UAC and SBP at Day 120 were - 65.1%, -75.9% and - 9.7%. Ten dogs (36.7%) achieved UPC < 1.0 at Day 120, of which six dogs had UPC < 0.5. A reduction of UPC to ≥50% was achieved in 10 dogs (36%) at Day 45 and 17 dogs (61%) at Day 120. Seventeen dogs (61%) had hypertension at baseline, of which 10 dogs (59%) had SBP < 160 mmHg at Day 120. Two-way repeated measures analysis of variance did not attribute the observed changes in SBP, UPC or UAC to feeding with a renal diet. In conclusion, telmisartan therapy provides anti-proteinuric and anti-hypertensive effects in dogs with proteinuric CKD.
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Affiliation(s)
- Yuichi Miyagawa
- The Laboratory of Veterinary Internal Medicine II, School of Veterinary Medicine, Faculty of Veterinary Science, Nippon Veterinary and Life Science University, 1-7-1 Kyonan Cho, Musashino-shi, 180-8602 Tokyo, Japan.
| | - Ryota Akabane
- The Laboratory of Veterinary Internal Medicine II, School of Veterinary Medicine, Faculty of Veterinary Science, Nippon Veterinary and Life Science University, 1-7-1 Kyonan Cho, Musashino-shi, 180-8602 Tokyo, Japan
| | - Atsushi Sakatani
- The Laboratory of Veterinary Internal Medicine II, School of Veterinary Medicine, Faculty of Veterinary Science, Nippon Veterinary and Life Science University, 1-7-1 Kyonan Cho, Musashino-shi, 180-8602 Tokyo, Japan
| | - Mizuki Ogawa
- The Laboratory of Veterinary Internal Medicine II, School of Veterinary Medicine, Faculty of Veterinary Science, Nippon Veterinary and Life Science University, 1-7-1 Kyonan Cho, Musashino-shi, 180-8602 Tokyo, Japan
| | - Masayoshi Nagakawa
- The Laboratory of Veterinary Internal Medicine II, School of Veterinary Medicine, Faculty of Veterinary Science, Nippon Veterinary and Life Science University, 1-7-1 Kyonan Cho, Musashino-shi, 180-8602 Tokyo, Japan
| | - Hirosumi Miyakawa
- The Laboratory of Veterinary Internal Medicine II, School of Veterinary Medicine, Faculty of Veterinary Science, Nippon Veterinary and Life Science University, 1-7-1 Kyonan Cho, Musashino-shi, 180-8602 Tokyo, Japan
| | - Naoyuki Takemura
- The Laboratory of Veterinary Internal Medicine II, School of Veterinary Medicine, Faculty of Veterinary Science, Nippon Veterinary and Life Science University, 1-7-1 Kyonan Cho, Musashino-shi, 180-8602 Tokyo, Japan
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9
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Koçer G, Basralı F, Kuru O, Şentürk ÜK. The Renin-Angiotensin System, Not the Kinin-Kallikrein System, Affects Post-Exercise Proteinuria. Nephron Clin Pract 2018; 139:299-304. [PMID: 29772567 DOI: 10.1159/000489506] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2017] [Accepted: 04/22/2018] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND/AIMS Temporary proteinuria post-exercise is common and is caused predominantly by renal haemodynamic alterations. One reason is up-regulation of angiotensin II (Ang II) due to the reducing effect of angiotensin-converting enzyme (ACE) inhibitors. However, another, ignored, reason could be the kininase effect of ACE inhibition. This study investigated how ACE inhibition reduces post-exercise proteinuria: by either Ang II up-regulation inhibition or bradykinin elevation due to kininase activity inhibition. METHODS Our study included 10 volunteers, who completed 3 high-intensity exercise protocols involving cycling at 1-week intervals. The first protocol was a control arm, the second evaluated the effect of ACE inhibition and the third examined the effect of angiotensin type 1 receptor blockade. Upon application, both agents reduced systolic and diastolic blood pressure; however, there were no statistically significant -differences. In addition, total protein, microalbumin and -β2-microglobulin excretion levels in urine specimens were analysed before, 30 min after and 120 min after the exercise protocols. RESULTS Total protein levels in urine samples were elevated in all 3 protocols after 30 min of high-intensity exercise, compared to baseline levels. However, both ACE inhibition and angiotensin type 1 receptor blockade suppressed total protein in the 30th min. In each protocol, total protein levels returned to the baseline after 120 min. Urinary microalbumin and β2-microglobulin levels during the control protocol were significantly higher 30 min post-exercise; however, only angiotensin type 1 receptor blockade suppressed microalbumin levels. CONCLUSION The results indicated Ang II up-regulation, not bradykinin elevation, plays a role in post-exercise proteinuria.
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Affiliation(s)
- Günnur Koçer
- Department of Physiology, Near East University, Medical Faculty, Nicosia, Cyprus
| | - Filiz Basralı
- Department of Physiology, Akdeniz University, Medical Faculty, Antalya, Turkey
| | - Oktay Kuru
- Department of Physical Therapy and Rehabilitation, Muğla Sıtkı Koçman University, Faculty of Health Sciences, Muğla, Turkey
| | - Ümit Kemal Şentürk
- Department of Physiology, Akdeniz University, Medical Faculty, Antalya, Turkey
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10
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King J, Font A, Rousselot J, Ash R, Bonfanti U, Brovida C, Crowe I, Lanore D, Pechereau D, Seewald W, Strehlau G. Effects of Benazepril on Survival of Dogs with Chronic Kidney Disease: A Multicenter, Randomized, Blinded, Placebo-Controlled Clinical Trial. J Vet Intern Med 2017; 31:1113-1122. [PMID: 28669137 PMCID: PMC5508345 DOI: 10.1111/jvim.14726] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2016] [Revised: 02/16/2017] [Accepted: 04/06/2017] [Indexed: 01/10/2023] Open
Abstract
BACKGROUND Chronic kidney disease (CKD) is an important cause of morbidity and mortality in dogs. OBJECTIVE To evaluate the efficacy in prolonging survival and safety of benazepril administration to dogs with CKD. ANIMALS Forty-nine client-owned dogs with CKD. METHODS Dogs were randomized to benazepril (0.25 to <0.5 mg/kg) or placebo once daily for up to 2 years in a prospective, multicenter, blinded clinical trial. The primary endpoint variable was the renal survival time, defined as the time from inclusion in the study to the treatment failure endpoint of death or euthanasia or need for administration of parenteral fluids related to renal failure. RESULTS No benefit of benazepril versus placebo was detected for renal survival time in all dogs; median (95% confidence interval (CI)) survival times were 305 (53-575) days in the benazepril group and 287 (152-not available) in the placebo group (P = .53). Renal survival times were not significantly longer with benazepril compared to placebo for subgroups: hazard ratios (95% CI) were 0.50 (0.21-1.22) with P = .12 for initial urine protein-to-creatinine ratio (UPC) >0.5, and 0.38 (0.12-1.19) with P = .080 for initial UPC >0.5 plus plasma creatinine ≤440 μmol/L. Proteinuria, assessed from the UPC, was significantly (P = .0032) lower after treatment with benazepril compared to placebo. There were no significant differences between groups for clinical signs or frequencies of adverse events. CONCLUSIONS AND CLINICAL RELEVANCE Benazepril significantly reduced proteinuria in dogs with CKD. Insufficient numbers of dogs were recruited to allow conclusions on survival time.
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Affiliation(s)
- J.N. King
- Elanco Animal HealthBaselSwitzerland
| | - A. Font
- Hospitar Ars VeterinariaBarcelonaSpain
| | | | - R.A. Ash
- Grove Lodge Veterinary GroupBrightonUK
| | - U. Bonfanti
- La Vallonèa Veterinary Diagnostic LaboratoryAlessanoItaly
| | - C. Brovida
- ANUBI Ospedale per Animali da CompagniaMoncalieri/TorinoItaly
| | | | - D. Lanore
- Clinique Vétérinaire AllianceBordeauxFrance
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