Oxytetracycline associated acute kidney injury in a neonatal foal

A 3-day-old Australian Stock Horse filly presented with fulminant acute kidney injury after receiving 4 g of intravenous oxytetracycline at 24 and 48 h of age for medical management of flexural deformities. The filly’s clinical status initially improved, but worsening azotaemia prompted euthanasia after 55 h of supportive care. Necropsy confirmed proximal tubular necrosis. Nephropathy in association with oxytetracycline administration has been rarely reported. This case describes severe nephropathy in an apparently normal foal and highlights the need for thorough case evaluation prior to use of high-dose oxytetracycline therapy for correction of flexural deformities in foals.     

黄秋葵醇提物对顺铂致急性肾损伤的保护作用

为了探讨黄秋葵嫩果醇提物对顺铂致小鼠急性肾损伤是否具有保护作用,将50只SPF级ICR雄性小鼠随机均分为空白对照组(0.9%生理盐水)、模型组(0.9%生理盐水)、黄秋葵醇提物(HQK)高中低剂量组(400、200、100 mg/kg),分别灌胃给药7 d,除空白对照组,于第7天给药1 h后灌胃给顺铂20 mg/kg。再灌胃给药3 d后,眼球取血,测定血清中尿素氮(BUN)、肌酐(CRE)、超氧化物歧化酶(SOD)、还原型谷胱甘肽(GSH)和丙二醛(MDA)的含量;测定肾脏匀浆中SOD、GSH和MDA含量;并观察苏木精-伊红(HE)病理切片组织病理学变化。结果表明:与模型组比较,HQK高、中剂量组中BUN、CRE含量均降低,肾组织GSH、SOD含量均升高(P0.01,P0.05),HE染色观察HQK高剂量组可显著保护顺铂致肾组织病理损害。黄秋葵醇提取物对CDDP诱导的小鼠急性肾损伤均有一定的保护作用。     

Perioperative urinary heat shock protein 72 as an early marker of acute kidney injury in dogs

ObjectiveAcute kidney injury (AKI) may be a complication in dogs undergoing surgery. Urinary heat shock protein 72 (uHSP72) is a sensitive biomarker of canine AKI. To assess the occurrence of perioperative AKI, based on uHSP72 compared with serum creatinine (sCr), and whether its occurrence is associated with the American Society of Anesthesiology physical status (ASA status).Study designClinical prospective study.AnimalsA total of 80 client-owned and shelter dogs.MethodsDogs scheduled for elective or emergency surgery were assigned ASA status (ASA I–IV). Preoperative and 24 hour postoperative serum and urine samples were collected. sCr, uHSP72 and urinary creatinine (uCr) were measured.ResultsPostoperative uHSP72/uCr concentration [median (range)] of all dogs undergoing surgery [2.40 (0.14–252) ng mg⁻¹] was significantly increased compared with preoperative uHSP72/uCr [1.30 (0.11–142) ng mg⁻¹] concentration (p < 0.001). Conversely, postoperative sCr concentration of all dogs [0.88 (0.3–1.6) mg dL⁻¹] significantly decreased compared with preoperative sCr concentration [0.8 (0.2–5.0) mg dL⁻¹; p = 0.001]. Median uHSP72/uCr concentration differed both preoperatively (p = 0.007) and postoperatively (p = 0.019) among the ASA status groups. Increased uHSP/uCr was measured in 20 dogs preoperatively and 33 dogs postoperatively, whereas only five dogs fulfilled the criteria of AKI based on sCr.ConclusionsThe occurrence of increased uHSP72/uCr perioperatively suggests that the proportion of dogs with AKI is considerably higher than perceived.Clinical relevanceDogs undergoing surgery should be closely monitored for AKI before and after anesthesia, using currently available markers (e.g., sCr) and more sensitive markers.     

A novel clinical scoring system for outcome prediction in dogs with acute kidney injury managed by hemodialysis

BACKGROUND: No reliable tool to predict outcome of acute kidney injury (AKI) exists. HYPOTHESIS: A statistically derived scoring system can accurately predict outcome in dogs with AKI managed with hemodialysis. ANIMALS: One hundred and eighty-two client-owned dogs with AKI. METHODS: Logistic regression analyses were performed initially on clinical variables available on the 1st day of hospitalization for relevance to outcome. Variables with P< or = .1 were considered for further analyses. Continuous variables outside the reference range were divided into quartiles to yield quartile-specific odds ratios (ORs) for survival. Models were developed by incorporating weighting factors assigned to each quartile based on the OR, using either the integer value of the OR (Model A) or the exact OR (Models B or C, when the etiology was known). A predictive score for each model was calculated for each dog by summing all weighting factors. In Model D, actual values for continuous variables were used in a logistic regression model. Receiver-operating curve analyses were performed to assess sensitivities, specificities, and optimal cutoff points for all models. RESULTS: Higher scores were associated with decreased probability of survival (P < .001). Models A, B, C, and D correctly classified outcomes in 81, 83, 87, and 76% of cases, respectively, and optimal sensitivities/specificities were 77/85, 81/85, 83/90 and 92/61%, respectively. CONCLUSIONS AND CLINICAL RELEVANCE: The models allowed outcome prediction that corresponded with actual outcome in our cohort. However, each model should be validated further in independent cohorts. The models may also be useful to assess AKI severity.     

Positive correlation between renal tubular flattening and renal tubular injury/interstitial fibrosis in murine kidney disease models

The number of patients with chronic kidney disease (CKD) is growing continuously globally. In order to study pathogenesis and mechanisms, many animal models have been developed, including spontaneous, genetic, and induced models. Although each type of CKD shows disease-specific tissue changes in the early stages, tubular disorder and interstitial fibrosis histologically occur in the course of progression to end-stage renal failure. Therefore, the quantification of tubular disorder and interstitial fibrosis in CKD research using animal models is essential for measuring the degree of CKD severity and, thus, efficacy of therapeutic agents. Several strategies have been used to quantify interstitial fibrosis. Among scoring factors, renal tubular flattening can be quantitatively evaluated easily and inexpensively. However, the diagnostic value of renal tubular flattening evaluation has not been investigated previously. Therefore, in this study, we investigated the correlation between renal tubular flattening and interstitial fibrosis or renal tubular injury markers. We observed a strong correlation between the degree of tubular injury/interstitial fibrosis and renal tubular flattening in three types of mouse renal disease model. This is advantageous because rapidly advancing technologies such as artificial intelligence and image processing can be easily applied; hence, a more precise, objective, and quantitative diagnosis should be possible in the future.     

血清胱抑素C在犬急性肾损伤中的早期诊断意义

为了探讨血清胱抑素C(cystatin C,Cys-C)在犬急性肾损伤(AKI)中的早期诊断意义,将40只体重8~10 kg、年龄1~2岁的中华田园犬随机为对照组和试验组,连续7 d静脉注射0.9%生理盐水注射液200 m L,试验组额外添加90 mg/kg硫酸庆大霉素建立AKI模型,采集血液及尿液进行血清肌酐(CREA)、尿素氮(BUN)、Cys-C、尿比重、尿蛋白及尿沉渣的检查,并于造模第0、3、5、7、10天进行肾脏病理学检查。结果显示:对照组各项指标都未出现显著性差异(P0.05);试验组血清Cys-C浓度从造模第3天出现显著差异(P0.05),而血清中CREA和BUN分别自造模第6和7天出现显著差异(P0.05)。结果表明:血清CYs-C在犬AKI的诊断中比血清CREA、BUN更具有早期诊断意义。     

Bilateral renal ischemia as a model of acute kidney injury in cats

The objective of this study was to evaluate the effect of 1h, bilateral, warm ischemia-reperfusion kidney injury as a model of acute kidney injury in the cat. Four adult healthy cats underwent 60 min of bilateral, in vivo renal warm ischemia; three cats were sham operated controls. Kidney function was evaluated with creatinine and BUN concentration, urine protein: creatinine, and glomerular filtration rate. Post-reperfusion endothelin and renin was measured by ELISA and RT-qPCR. Blood pressure (BP), platelet count, and platelet aggregation were monitored. Renal biopsy specimens were evaluated histopathologically. There was significant reduction in renal function characterized by severe azotemia and proximal tubular brush border loss. Changes in renin or endothelin gene expression or serum concentration were not detected. No changes were detected in BP. Platelet count and hematocrit decreased markedly after ischemia and reperfusion. Sixty minutes bilateral renal ischemia is an effective model for acute renal injury.