通过血液透析有效清除患有严重急性和慢性肾损伤的狗体内的钆。

IF 1.1 3区农林科学 Q3 VETERINARY SCIENCES

Journal of veterinary emergency and critical care Pub Date : 2024-07-07 DOI:10.1111/vec.13404

Daniel S. Gordon DVM, MS, DACVECC, Cathy E. Langston DVM, DACVIM

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引用次数: 0

摘要

目的：病例摘要：一只 12 岁的阉割雌性约克夏梗犬患有严重的急性-慢性肾损伤，并同时伴有神经症状。作为治疗的一部分，该犬接受了体外疗法。血液透析后，尿毒症有所好转，但中枢神经系统症状依然存在；因此，对其进行了造影剂增强磁共振成像检查，随后立即进行了 IHD 治疗。在使用钆后 1.5 小时和 25.75 小时，使用低通量透析器进行了两次 IHD 治疗，几乎完全清除了钆。一次治疗就清除了 96% 以上的钆：提供的新信息或独特信息：体外疗法能有效清除钆螯合造影剂，如果肾功能严重受损的患者需要进行磁共振成像，可以考虑使用体外疗法。此外，还可以使用被认为对这类患者更安全的新型造影剂。

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Effective removal of gadolinium with hemodialysis in a dog with severe acute on chronic kidney injury

Objective

To describe the use of intermittent hemodialysis (IHD) to remove gadolinium (28.1 mg/kg dose) in a dog with severe kidney disease.

Case Summary

A 12-year-old neutered female Yorkshire Terrier presented with severe acute-on-chronic kidney injury and concurrent neurological signs. The dog received extracorporeal therapy as part of management. Uremia improved after hemodialysis, but central nervous system signs persisted; therefore, a contrast-enhanced magnetic resonance imaging was performed, immediately followed by IHD. Two IHD treatments with a low-flux dialyzer were performed 1.5 and 25.75 hours after administration of gadolinium, with almost complete removal of gadolinium. More than 96% of gadolinium was removed with a single treatment.

New or Unique Information Provided

Extracorporeal therapy is effective at removing gadolinium-based chelated contrast agents and could be considered if magnetic resonance imaging is indicated in a patient with substantial kidney impairment. Alternatively, newer contrast agents that have been deemed safer in this patient population could be used.

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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.