Frequency and progression of azotemia during acute and chronic treatment of congestive heart failure in cats.

Autor: Rogg S; Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Iowa State University, Ames, Iowa, USA., Mochel JP; SMART Pharmacology, Precision One Health Initiative, Department of Veterinary Pathology, University of Georgia, Athens, Georgia, USA., Kundu D; Department of Statistics, Iowa State University, Ames, Iowa, USA., Tropf MA; Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Iowa State University, Ames, Iowa, USA., Masters AK; Department of Veterinary Clinical Sciences, University of Minnesota, Saint Paul, Minnesota, USA., Adin DB; Department of Small Animal Clinical Sciences, College of Veterinary Medicine, University of Florida, Gainesville, Florida, USA., Ward JL; Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Iowa State University, Ames, Iowa, USA.
Jazyk: angličtina
Zdroj: Journal of veterinary internal medicine [J Vet Intern Med] 2025 Jan-Feb; Vol. 39 (1), pp. e17254. Date of Electronic Publication: 2024 Nov 26.
DOI: 10.1111/jvim.17254
Abstrakt: Background: Azotemia is common in cats with congestive heart failure (CHF) and might be exacerbated by diuretic therapy.
Hypothesis/objectives: Determine frequency, risk factors, and survival impact of progressive azotemia in cats treated for CHF.
Animals: One hundred and sixteen client-owned cats with kidney function testing performed at least twice during acute or chronic CHF treatment.
Methods: Serum creatinine (sCr) and electrolyte concentrations were determined at multiple clinical timepoints to detect azotemia and kidney injury (KI; sCr increase ≥0.3 mg/dL). Furosemide dosage between timepoints was calculated. Multivariable modeling was performed to identify predictors of KI, change in serum biochemistry results, and survival.
Results: Azotemia was common at all timepoints, including initial CHF diagnosis (44%). Kidney injury was documented in 66% of cats. Use of a furosemide continuous rate infusion was associated with increased risk of KI during hospitalization (odds ratio, 141.6; 95% confidence interval [CI], 12.1-6233; P = .01). Higher furosemide dosage was associated with increase in sCr during hospitalization (P = .03) and at first reevaluation (P = .01). Treatment with an angiotensin converting enzyme inhibitor was associated with fewer lifetime KI events (P = .02). Age in years was the only variable associated with shorter survival (hazard ratio, 1.1; 95% CI, 1.0-1.1; P = .03). Neither sCr nor KI were associated with long-term outcome.
Conclusions and Clinical Importance: Azotemia and KI were common in cats during CHF treatment but did not impact survival.
(© 2024 The Author(s). Journal of Veterinary Internal Medicine published by Wiley Periodicals LLC on behalf of American College of Veterinary Internal Medicine.)
Databáze: MEDLINE
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