Exploring urinary biomarkers of early acute kidney injury in a clinical model of canine intraoperative hypotension: an observational cohort study

IF 1.9 2区农林科学 Q2 VETERINARY SCIENCES

Veterinary anaesthesia and analgesia Pub Date : 2025-05-01 DOI:10.1016/j.vaa.2025.02.005

Benjamin W. Chen, Jennifer Davis, Gabriele Rossi, Giselle L. Hosgood, Anthea L. Raisis

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Abstract

Objective

To explore changes in urinary biomarkers of acute kidney injury (AKI) in healthy dogs experiencing intraoperative hypotension and explore the relationship between blood pressure and urinary biomarkers.

Study design

Observational cohort study.

Animals

A group of 50 client-owned dogs.

Methods

Urine and blood samples were collected prior to anaesthesia (T0), within 24 hours after anaesthesia (T1) and 10 days post-surgery (T10). During anaesthesia, the lowest mean arterial pressure (MAP) in each dog was identified. Impact of duration was explored by categorizing according to arbitrary thresholds of MAP < 50, < 60, < 70 and < 80 mmHg and calculating duration (minutes) within each category. Serum creatinine (Cr) and validated biomarkers of AKI including urinary gamma-glutamyl transferase (uGGT), urinary neutrophil gelatinase-associated lipocalin (uNGAL) and urinary cystatin C (uCystatin C) were measured. Biomarker measurements were standardized to urinary Cr. The frequency of dogs with proportional increases between T1 and T0 and between T10 and T0 was recorded. Multiple regression analysis determined the simplest subset of independent variables (lowest MAP, duration with each MAP category) to best explain the variance in the proportional change of each biomarker.

Results

Hypotension, defined as MAP < 60 mmHg, was observed in 38/50 (76%) of the dogs. Between T1 and T0, increases in uGGT/Cr, uCystatin C/Cr and uNGAL/Cr were observed in 37 (82%), 17 (41 %) and 19 (35%) of 50 dogs, respectively. Of the variance observed in uGGT/Cr at T1/T0, 62% could be explained by the lowest MAP recorded when combined with duration MAP < 50 mmHg (adjusted R² 0.62).

Conclusions and clinical relevance

In this clinical model of intraoperative hypotension, uGGT/Cr demonstrated potential for diagnosis of early AKI. The use of other validated biomarkers of AKI requires further investigation to establish their clinical relevance in diagnosis of post-anaesthetic kidney injury.

查看原文本刊更多论文

在犬术中低血压临床模型中探索早期急性肾损伤的尿液生物标志物：一项观察性队列研究。

研究目的探讨术中低血压的健康犬急性肾损伤（AKI）尿液生物标志物的变化，并探讨血压与尿液生物标志物之间的关系：观察性队列研究：研究设计：观察性队列研究：收集麻醉前（T0）、麻醉后 24 小时内（T1）和手术后 10 天内（T10）的尿液和血液样本。在麻醉期间，确定每只狗的最低平均动脉压 (MAP)。根据 MAP < 50、< 60、< 70 和 < 80 mmHg 的任意阈值进行分类，并计算每个类别中的持续时间（分钟），从而探讨持续时间的影响。测量血清肌酐（Cr）和有效的 AKI 生物标志物，包括尿γ-谷氨酰转移酶（uGGT）、尿中性粒细胞明胶酶相关脂褐质（uNGAL）和尿胱抑素 C（uCystatin C）。生物标志物测量结果与尿 Cr 一致。记录了 T1 和 T0 之间以及 T10 和 T0 之间呈比例增长的犬的频率。多元回归分析确定了最简单的自变量子集（最低 MAP、每个 MAP 类别的持续时间），以最好地解释每个生物标志物比例变化的差异：38/50（76%）只狗出现了低血压，即 MAP < 60 mmHg。在 T1 和 T0 之间，50 只狗中分别有 37 只（82%）、17 只（41 %）和 19 只（35%）观察到 uGGT/Cr、u胱抑素 C/Cr 和 uNGAL/Cr 的增加。在 T1/T0 阶段观察到的 uGGT/Cr 变异中，62% 可以用记录到的最低 MAP 结合持续时间 MAP < 50 mmHg 来解释（调整后 R2 为 0.62）：在这个术中低血压临床模型中，uGGT/Cr 显示出诊断早期 AKI 的潜力。其他已验证的 AKI 生物标志物的使用需要进一步研究，以确定其在诊断麻醉后肾损伤中的临床意义。

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

Veterinary anaesthesia and analgesia 农林科学-兽医学

CiteScore

3.10

自引率

17.60%

发文量

审稿时长

97 days

期刊介绍： Veterinary Anaesthesia and Analgesia is the official journal of the Association of Veterinary Anaesthetists, the American College of Veterinary Anesthesia and Analgesia and the European College of Veterinary Anaesthesia and Analgesia. Its purpose is the publication of original, peer reviewed articles covering all branches of anaesthesia and the relief of pain in animals. Articles concerned with the following subjects related to anaesthesia and analgesia are also welcome: the basic sciences; pathophysiology of disease as it relates to anaesthetic management equipment intensive care chemical restraint of animals including laboratory animals, wildlife and exotic animals welfare issues associated with pain and distress education in veterinary anaesthesia and analgesia. Review articles, special articles, and historical notes will also be published, along with editorials, case reports in the form of letters to the editor, and book reviews. There is also an active correspondence section.