Evaluation of a prognostic scoring system for dogs managed with hemodialysis

J Vet Emerg Crit Care (San Antonio). 2018 Jul;28(4):340-345. doi: 10.1111/vec.12736. Epub 2018 Jun 24.

Abstract

Objective: To investigate prognostic models in a cohort of dogs with acute kidney injury (AKI) and acute on chronic kidney disease (AKI/CKD) managed by hemodialysis.

Design: Retrospective study from July 2011 to November 2014.

Setting: University Veterinary Teaching Hospital.

Animals: Forty dogs with historical, clinical, imaging, and laboratory findings consistent with AKI or AKI/CKD managed with intermittent hemodialysis were included.

Interventions: Scoring system models previously established by Segev et al for outcome prediction in dogs with AKI were applied to all dogs.

Results: Models A, B, and C correctly classified outcomes in 68%, 83%, and 85% of cases, respectively. In our cohort Model A showed sensitivity of 58% and specificity of 86%, Model B showed sensitivity of 79% and specificity of 87%, Model C showed sensitivity of 86% and specificity of 84%. The presence of anuria (P < 0.0002), respiratory complications (P < 0.0001), disseminated intravascular coagulation (DIC) (P = 0.0004), grade of AKI (P = 0.0023), pancreatitis (P = 0.0001), and systemic inflammatory response syndrome (SIRS) (P = 0.0001) was significantly higher in nonsurvivors compared with survivors.

Conclusions: In our cohort of patients, Segev's model C showed the best sensitivity and specificity for predicting prognosis, while model A had lower sensitivity. In our cohort of dialysis patients, the presence of respiratory complications, DIC, SIRS, and pancreatitis at hospitalization, were correlated with a poor prognosis.

Keywords: AKI; IRIS grading; dogs; hemodialysis; prognosis.

Publication types

  • Evaluation Study

MeSH terms

  • Acute Kidney Injury / therapy
  • Acute Kidney Injury / veterinary*
  • Animals
  • Dog Diseases / pathology
  • Dog Diseases / therapy*
  • Dogs
  • Female
  • Male
  • Prognosis
  • Renal Dialysis / veterinary*
  • Retrospective Studies
  • Sensitivity and Specificity
  • Severity of Illness Index*
  • Systemic Inflammatory Response Syndrome / therapy
  • Systemic Inflammatory Response Syndrome / veterinary*