Dataset Information

Fractional excretion of electrolytes in volume-responsive and intrinsic acute kidney injury in dogs: Diagnostic and prognostic implications.

ABSTRACT:

Background

The value of fractional excretion (FE) of electrolytes to characterize and prognosticate acute kidney injury (AKI) is poorly documented in dogs.

Objectives

To evaluate the diagnostic and prognostic roles of FE of electrolytes in dogs with AKI.

Animals

Dogs (n?=?135) with AKI treated with standard care (February 2014-December 2016).

Methods

Prospective study. Clinical and laboratory variables including FE of electrolytes, were measured upon admission. Dogs were graded according to the AKI-IRIS guidelines and grouped according to AKI features (volume-responsive, VR-AKI; intrinsic, I-AKI) and outcome (survivors/non-survivors). Group comparison and regression analyses with hazard ratios (HR) evaluation for I-AKI and mortality were performed. P?ResultsFifty-two of 135 (39%) dogs had VR-AKI, 69/135 (51%) I-AKI and 14/135 (10%) were unclassified. I-AKI dogs had significantly higher FE of electrolytes, for example, FE of sodium (FENa, %) 2.39 (range 0.04-75.81) than VR-AKI ones 0.24 (range 0.01-2.21; P?Conclusions and clinical importanceFractional excretion of electrolytes performed well in the early differentiation between VR-AKI and I-AKI, were related to outcome, and could be useful tools to manage AKI dogs in clinical practice.

SUBMITTER: Troia R

PROVIDER: S-EPMC6060310 | biostudies-literature | 2018 Jul

REPOSITORIES: biostudies-literature

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Publications

Fractional excretion of electrolytes in volume-responsive and intrinsic acute kidney injury in dogs: Diagnostic and prognostic implications.

Troìa Roberta R Gruarin Marta M Grisetti Chiara C Serafini Federica F Magna Luca L Monari Erika E Giunti Massimo M Dondi Francesco F

Journal of veterinary internal medicine 20180517 4

<h4>Background</h4>The value of fractional excretion (FE) of electrolytes to characterize and prognosticate acute kidney injury (AKI) is poorly documented in dogs.<h4>Objectives</h4>To evaluate the diagnostic and prognostic roles of FE of electrolytes in dogs with AKI.<h4>Animals</h4>Dogs (n = 135) with AKI treated with standard care (February 2014-December 2016).<h4>Methods</h4>Prospective study. Clinical and laboratory variables including FE of electrolytes, were measured upon admission. Dogs ...[more]

PMID: 29770972

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Project description:Background and objectivesAKI is classified as prerenal, intrinsic, and postrenal. Prerenal AKI and intrinsic AKI represent the most common causes for AKI in hospitalized patients. This study aimed to examine the accuracy of the fractional excretion of sodium for distinguishing intrinsic from prerenal AKI.Design, setting, participants, & measurementsWe searched MEDLINE, Embase, Cochrane Central Register of Controlled Trials, the Cochrane Library, and Scopus for all available studies that met the criteria until December 31, 2021. We included studies that evaluated fractional excretion of sodium in differentiating AKI etiologies in adults, whereas studies that did not have sufficient data to extract a 2×2 table were excluded. We assessed the methodologic quality using the Quality Assessment of Diagnostic Accuracy Studies-2 tool and extracted the diagnostic accuracy data for all included studies. We conducted a meta-analysis using the bivariate random effects model. We performed subgroup analysis to investigate sources of heterogeneity and the effect of the relevant confounders on fractional excretion of sodium accuracy.ResultsWe included 19 studies with 1287 patients. In a subset of 15 studies (872 patients) that used a threshold of 1%, the pooled sensitivity and specificity for differentiating intrinsic from prerenal AKI were 90% (95% confidence interval, 81% to 95%) and 82% (95% confidence interval, 70% to 90%), respectively. In a subgroup of six studies (511 patients) that included CKD or patients on diuretics, the pooled sensitivity and specificity were 83% (95% confidence interval, 64% to 93%) and 66% (95% confidence interval, 51% to 78%), respectively. In five studies with 238 patients on diuretics, the pooled sensitivity and specificity were 80% (95% confidence interval, 69% to 87%) and 54% (95% confidence interval, 31% to 75%), respectively. In eight studies with 264 oliguric patients with no history of CKD or diuretic therapy, the pooled sensitivity and specificity were 95% (95% confidence interval, 82% to 99%) and 91% (95% confidence interval, 83% to 95%), respectively.ConclusionsFractional excretion of sodium has a limited role for AKI differentiation in patients with a history of CKD or those on diuretic therapy. It is most valuable when oliguria is present.

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Dataset Information

Fractional excretion of electrolytes in volume-responsive and intrinsic acute kidney injury in dogs: Diagnostic and prognostic implications.

Background

Objectives

Animals

Methods

Publications

Fractional excretion of electrolytes in volume-responsive and intrinsic acute kidney injury in dogs: Diagnostic and prognostic implications.

Similar Datasets

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