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Prospective evaluation of novel biomarkers of acute kidney injury in dogs following cardiac surgery under cardiopulmonary bypass.
J Vet Emerg Crit Care (San Antonio). 2022 Nov; 32(6):733-742.JV

Abstract

OBJECTIVE

To assess the occurrence of acute kidney injury (AKI) in dogs undergoing cardiac surgery under cardiopulmonary bypass (CPB) and explore associations between traditional and novel serum and urinary biomarkers.

DESIGN

Prospective cohort study conducted between July 2018 and April 2019.

SETTING

University teaching hospital.

ANIMALS

Nineteen dogs undergoing cardiac surgery under CPB with preoperative serum creatinine <140 μmol/L (<1.6 mg/dl).

INTERVENTIONS

Blood and urine samples were obtained at 4 time points: preoperatively following general anesthesia induction, immediately postoperatively, and 2 and 4 days postoperatively (T1 , T2 , T3 , and T4). AKI was defined as an increase in serum creatinine ≥26.4 μmol/L (≥0.3 mg/dl) above baseline within 48 hours. Serum creatinine, C-reactive protein (CRP), symmetric dimethylarginine (SDMA), inosine, beta-aminoisobutyric acid (BAIB), urinary clusterin (uClus), and urinary cystatin B (uCysB) were measured. Data were log-transformed (log10) when appropriate and assessed using linear mixed-effects models.

MEASUREMENTS AND MAIN RESULTS

AKI occurred in 3 of 19 dogs (15.8%, 95% confidence interval: 0.047-0.384). Inosine increased at T2 (adjusted mean ± standard error: 53 ± 5.6) in all dogs, and then gradually decreased. Log10 uCysB increased at T2 (2.3 ± 0.1) in all dogs and remained high. Log10 CRP and log10 uClus increased significantly at T3 (1.9 ± 0.1 and 3.6 ± 0.1, respectively) in all dogs and remained increased. There was a significant positive association between serum creatinine and SDMA (P < 0.001, estimate ± standard error: 0.06 ± 0.00), between log10 CRP and log10 uClus (P < 0.001, 0.35 ± 0.08), between SDMA and creatinine as well as between SDMA and BAIB (P < 0.001, 11.1 ± 0.83 and P < 0.001, 1.06 ± 0.22, respectively) for all dogs at all time points.

CONCLUSIONS

Inosine and uCysB concentrations changed in all dogs immediately following a surgery under CPB and may indicate tubular injury. Further studies are required to ascertain the usefulness of those biomarkers in early detection of AKI.

Links

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Authors+Show Affiliations

Starybrat D
Department of Clinical Science and Services, The Royal Veterinary College, University of London, London, UK.
Jepson R
Department of Clinical Science and Services, The Royal Veterinary College, University of London, London, UK.
Bristow P
Department of Clinical Science and Services, The Royal Veterinary College, University of London, London, UK. Dick White Referrals, Six Mile-Bottom, Cambridgeshire, CB8 0UH, UK.
Peterson S
IDEXX Laboratories, Inc, Westbrook, Maine, USA.
Yerramilli M
Translation Medicine/BioMarker Development, Novartis Institute of Biomedical Research Inc., Cambridge, Massachusetts, USA.
Yerramilli M
IDEXX Laboratories, Inc, Westbrook, Maine, USA.
Chang YM
Department of Comparative Biomedical Sciences, The Royal Veterinary College, University of London, London, UK.
Cortellini S
Department of Clinical Science and Services, The Royal Veterinary College, University of London, London, UK.

MeSH

DogsAnimalsCardiopulmonary BypassCreatinineProspective StudiesPredictive Value of TestsAcute Kidney InjuryCardiac Surgical ProceduresBiomarkersC-Reactive ProteinInosineDog Diseases

Pub Type(s)

Journal Article

Language

eng

PubMed ID

36125401

Citation

Starybrat, Daria, et al. "Prospective Evaluation of Novel Biomarkers of Acute Kidney Injury in Dogs Following Cardiac Surgery Under Cardiopulmonary Bypass." Journal of Veterinary Emergency and Critical Care (San Antonio, Tex. : 2001), vol. 32, no. 6, 2022, pp. 733-742.
Starybrat D, Jepson R, Bristow P, et al. Prospective evaluation of novel biomarkers of acute kidney injury in dogs following cardiac surgery under cardiopulmonary bypass. J Vet Emerg Crit Care (San Antonio). 2022;32(6):733-742.
Starybrat, D., Jepson, R., Bristow, P., Peterson, S., Yerramilli, M., Yerramilli, M., Chang, Y. M., & Cortellini, S. (2022). Prospective evaluation of novel biomarkers of acute kidney injury in dogs following cardiac surgery under cardiopulmonary bypass. Journal of Veterinary Emergency and Critical Care (San Antonio, Tex. : 2001), 32(6), 733-742. https://doi.org/10.1111/vec.13250
Starybrat D, et al. Prospective Evaluation of Novel Biomarkers of Acute Kidney Injury in Dogs Following Cardiac Surgery Under Cardiopulmonary Bypass. J Vet Emerg Crit Care (San Antonio). 2022;32(6):733-742. PubMed PMID: 36125401.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Prospective evaluation of novel biomarkers of acute kidney injury in dogs following cardiac surgery under cardiopulmonary bypass. AU - Starybrat,Daria, AU - Jepson,Rosanne, AU - Bristow,Poppy, AU - Peterson,Sarah, AU - Yerramilli,Maha, AU - Yerramilli,Murthy, AU - Chang,Yu-Mei, AU - Cortellini,Stefano, Y1 - 2022/09/20/ PY - 2021/10/13/revised PY - 2021/07/21/received PY - 2021/11/12/accepted PY - 2022/9/21/pubmed PY - 2022/11/19/medline PY - 2022/9/20/entrez KW - AKI KW - BAIB KW - CPB KW - CRP KW - SDMA KW - clusterin KW - creatinine KW - cystatin B KW - inosine SP - 733 EP - 742 JF - Journal of veterinary emergency and critical care (San Antonio, Tex. : 2001) JO - J Vet Emerg Crit Care (San Antonio) VL - 32 IS - 6 N2 - OBJECTIVE: To assess the occurrence of acute kidney injury (AKI) in dogs undergoing cardiac surgery under cardiopulmonary bypass (CPB) and explore associations between traditional and novel serum and urinary biomarkers. DESIGN: Prospective cohort study conducted between July 2018 and April 2019. SETTING: University teaching hospital. ANIMALS: Nineteen dogs undergoing cardiac surgery under CPB with preoperative serum creatinine <140 μmol/L (<1.6 mg/dl). INTERVENTIONS: Blood and urine samples were obtained at 4 time points: preoperatively following general anesthesia induction, immediately postoperatively, and 2 and 4 days postoperatively (T1 , T2 , T3 , and T4). AKI was defined as an increase in serum creatinine ≥26.4 μmol/L (≥0.3 mg/dl) above baseline within 48 hours. Serum creatinine, C-reactive protein (CRP), symmetric dimethylarginine (SDMA), inosine, beta-aminoisobutyric acid (BAIB), urinary clusterin (uClus), and urinary cystatin B (uCysB) were measured. Data were log-transformed (log10) when appropriate and assessed using linear mixed-effects models. MEASUREMENTS AND MAIN RESULTS: AKI occurred in 3 of 19 dogs (15.8%, 95% confidence interval: 0.047-0.384). Inosine increased at T2 (adjusted mean ± standard error: 53 ± 5.6) in all dogs, and then gradually decreased. Log10 uCysB increased at T2 (2.3 ± 0.1) in all dogs and remained high. Log10 CRP and log10 uClus increased significantly at T3 (1.9 ± 0.1 and 3.6 ± 0.1, respectively) in all dogs and remained increased. There was a significant positive association between serum creatinine and SDMA (P < 0.001, estimate ± standard error: 0.06 ± 0.00), between log10 CRP and log10 uClus (P < 0.001, 0.35 ± 0.08), between SDMA and creatinine as well as between SDMA and BAIB (P < 0.001, 11.1 ± 0.83 and P < 0.001, 1.06 ± 0.22, respectively) for all dogs at all time points. CONCLUSIONS: Inosine and uCysB concentrations changed in all dogs immediately following a surgery under CPB and may indicate tubular injury. Further studies are required to ascertain the usefulness of those biomarkers in early detection of AKI. SN - 1476-4431 UR - https://www.unboundmedicine.com/medline/citation/36125401/Prospective_evaluation_of_novel_biomarkers_of_acute_kidney_injury_in_dogs_following_cardiac_surgery_under_cardiopulmonary_bypass_ DB - PRIME DP - Unbound Medicine ER -