Retrospective evaluation of acute kidney injury in horses treated with nonnitrogenous bisphosphonates (2013–2020): 8 cases

IF 1.1 3区农林科学 Q3 VETERINARY SCIENCES

Journal of veterinary emergency and critical care Pub Date : 2023-09-11 DOI:10.1111/vec.13324

Lisa Edwards DVM, DACVIM, DACVECC, K. Gary Magdesian DVM, DACVIM, DACVECC, DACVCP

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引用次数: 0

Abstract

Objective

To describe a population of horses with acute kidney injury (AKI) following administration of bisphosphonates including clinical signs, clinicopathologic data, treatment, and outcome.

Design

Retrospective study from August 2013 to July 2020.

Setting

Veterinary university teaching hospital.

Animals

Eight adult horses with AKI following administration of nonnitrogenous bisphosphonates.

Interventions

None.

Measurements and Main Results

Five horses received intramuscular clodronate (5/8; 62.5%) and 3 horses received intravenous tiludronate (3/8; 37.5%). Six horses (6/8; 75%) received concurrent nonsteroidal anti-inflammatory drugs. The most common initial presenting complaint was poor appetite (6/8; 75%), followed by abnormal urination (2/8; 25%). At the time of initial evaluation, the mean serum or plasma creatinine was 451.72 ± 190.06 μmol/L (5.11 ± 2.15 mg/dL) and BUN was 18.84 ± 8.85 mmol/L (52.75 ± 24.77 mg/dL). Five horses (5/6; 83.3%) had either an increased number of red blood cells (n = 4) or hemoprotein (n = 1) in the urine. All horses were treated with IV isotonic, balanced crystalloids either as a bolus, continuous rate infusion, or a combination of the 2. Seven horses (7/8; 87.5%) survived the initial episode of AKI and 1 horse (1/8; 12.5%) was euthanized. Of the 7 surviving horses, 2 horses (2/7; 28.5%) went on to develop chronic renal dysfunction. Warmblood breeds were overrepresented in the AKI group (P = 0.008; odds ratio: 11.5, 95% confidence interval: 1.8–72.1), when compared to horses that received bisphosphonates during the study period and did not develop AKI.

Conclusions

Bisphosphonate administration, with or without concurrent nonsteroidal anti-inflammatory drugs, can be associated with AKI in horses. Serum creatinine should be monitored prior to and following bisphosphonate treatment to minimize this risk. Further evaluation of renal function is warranted in horses that develop clinical signs of poor appetite, lethargy, or altered urination in the days following bisphosphonate treatment.

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2013-2020年非含氮双膦酸盐治疗马急性肾损伤8例回顾性分析

目的:描述一群患有急性肾损伤(AKI)的马在服用双膦酸盐后的临床症状、临床病理数据、治疗和结果。设计:2013年8月至2020年7月的回顾性研究。单位:兽医大学附属医院。动物:8匹成年马在服用非含氮双磷酸盐后出现AKI。干预措施:没有。测量和主要结果:5匹马肌肉注射氯膦酸钠(5/8;62.5%)， 3匹马静脉注射替洛膦酸钠(3/8;37.5%)。六匹马(6/8;75%)同时服用非甾体抗炎药。最常见的首发主诉是食欲不振(6/8;75%)，其次是排尿异常(2/8;25%)。初测时血清或血浆肌酐平均值为451.72±190.06 μmol/L(5.11±2.15 mg/dL)， BUN平均值为18.84±8.85 mmol/L(52.75±24.77 mg/dL)。5匹马(5/6;83.3%)尿液中红细胞(n = 4)或血红蛋白(n = 1)增加。所有的马都接受静脉等渗、平衡的晶体药物治疗，可以是单次、连续输注，也可以是两者的结合。七匹马(7/8;87.5%)和1匹马(1/8;12.5%)被安乐死。幸存的7匹马中，2匹马(2/7;28.5%)发展为慢性肾功能障碍。温血犬在AKI组中比例过高(P = 0.008;优势比:11.5,95%可信区间:1.8-72.1)，与在研究期间接受双磷酸盐治疗且未发生AKI的马相比。结论:双膦酸盐给药，同时使用或不同时使用非甾体抗炎药，可与马的AKI相关。在双膦酸盐治疗前后应监测血清肌酐，以尽量减少这种风险。对在双膦酸盐治疗后出现食欲不振、嗜睡或排尿改变等临床症状的马进行进一步的肾功能评估是必要的。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of veterinary emergency and critical care 农林科学-兽医学

CiteScore

2.50

自引率

15.40%

发文量

121

审稿时长

18-36 weeks

期刊介绍： The Journal of Veterinary Emergency and Critical Care’s primary aim is to advance the international clinical standard of care for emergency/critical care patients of all species. The journal’s content is relevant to specialist and non-specialist veterinarians practicing emergency/critical care medicine. The journal achieves it aims by publishing descriptions of unique presentation or management; retrospective and prospective evaluations of prognosis, novel diagnosis, or therapy; translational basic science studies with clinical relevance; in depth reviews of pertinent topics; topical news and letters; and regular themed issues. The journal is the official publication of the Veterinary Emergency and Critical Care Society, the American College of Veterinary Emergency and Critical Care, the European Veterinary Emergency and Critical Care Society, and the European College of Veterinary Emergency and Critical Care. It is a bimonthly publication with international impact and adheres to currently accepted ethical standards.