Retrospective Evaluation of Acute Kidney Injury and Its Association With Severity and Outcome in Small Animal Trauma Patients: 387 Cases (2017–2021)

Objective

To describe the prevalence of acute kidney injury (AKI) in canine and feline trauma and to determine associations between AKI and trauma severity, outcome, species, and other factors.

Design

Analysis of cases submitted by one hospital to the Veterinary Committee on Trauma registry between April 2017 and February 2021 that had blood creatinine concentration measured within 6 h of presentation after trauma.

Setting

University teaching hospital in the United Kingdom.

Animals

A total of 220 canine and 167 feline trauma patients.

Measurements and Main Results

Azotemic AKI was defined as creatinine concentration > 140 µmol/L (1.58 mg/dL) and subgrouped by fluid responsiveness according to the International Renal Interest Society. Hospital-acquired AKI (HAAKI) was defined as a serial increase in creatinine concentration ≥ 26.4 µmol/L (≥ 0.3 mg/dL) from a nonazotemic baseline. Trauma severity, Animal Trauma Triage (ATT) score, survival, age, and species were compared between groups with and without AKI. Twenty-eight of 387 (7.24%) cases (23/167 [13.8% cats]; 5/220 [2.3% dogs]) had AKI on presentation. Cats were more likely to present with AKI than dogs (odds ratio: 4.95; 95% confidence interval, 2.36–10.8; P < 0.0001). Nine of 17 (52.9%) azotemic AKI patients in which serial creatinine concentrations were available had fluid-responsive AKI. HAAKI was documented in seven of 105 patients (6.67%). Median ATT score on presentation was higher in azotemic AKI than non-AKI cases (P = 0.02). Twenty-two of 28 (78.6%) azotemic AKI cases, three of seven (42.9%) HAAKI cases, and 316 of 359 (89.8%) non-AKI cases survived.

Conclusions

AKI occurs in canine and feline trauma and appears associated with higher trauma severity. Its impact on survival requires further investigation.